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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 365530072
Report Date: 12/12/2025
Date Signed: 12/12/2025 10:28:51 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/10/2025 and conducted by Evaluator Paola Guerrero
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20251110101047
FACILITY NAME:VILLA DESCANSO DE AMORFACILITY NUMBER:
365530072
ADMINISTRATOR:THOMPSON, GABRIELAFACILITY TYPE:
740
ADDRESS:15453 ELM LANETELEPHONE:
(909) 597-1349
CITY:CHINO HILLSSTATE: CAZIP CODE:
91709
CAPACITY:6CENSUS: 5DATE:
12/12/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Destinee Guzman- CaregiverTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff did not provide transportation to resident.
Staff prevent resident from communicating with social worker.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Paola Guerrero arrived at the facility to deliver investigative findings. LPA met with Facility Caregiver Destinee Guzman and explained the purpose of the visit regarding the allegations listed above.

First allegation: Staff did not provide transportation to resident. Regarding the allegation Licensing Program Analyst (LPA) conducted an interview with Resident#1 LPA went over the alleged allegation with R#1 and R#1 informed LPA that resident is responsible of their own scheduling of all medical appointments along with scheduling transportation furthermore, R#1 informed LPA that resident is the only one who can schedule and cancel transportation. Resident #1 informed LPA that the facility does not handle resident’s appointments nor does the facility have the ability cancel R#1 transportation. Licensing program analyst LPA conducted an interview with Staff#1 LPA went over the alleged allegation with S#1 and staff denied not providing or canceling R#1 transportation. S#1 informed LPA that R#1 is responsible of scheduling and canceling their own medical appointments along with their transportation.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 56-AS-20251110101047
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: VILLA DESCANSO DE AMOR
FACILITY NUMBER: 365530072
VISIT DATE: 12/12/2025
NARRATIVE
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Licensing Program Analyst (LPA) conducted an interview with Resident #1 regarding the alleged allegation R#1 informed LPA that R#1 had a scheduled appointment with InnovAge however, R#1 informed LPA that resident canceled and did not attend the appointment. Resident #1 informed LPA that later that day an InnovAge social worker rep arrived at the facility and Resident#1 informed staff that resident declined the visit and did not want to speak with the InnovAge rep. Licensing Program Analyst (LPA) conducted interviews with Staff #1-3 regarding the alleged allegation and all staff denied the allegation and informed LPA that staff informed R#1 about the visit however, R#1 declined and informed staff that R#1 did not want to speak with the InnovAge social worker. Based on corroborating evidence the department has determined that the above allegations are Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

An exit interview was conducted where this report (LIC 9099) was discussed, and a copy was provided to Facility Caregiver Destinee Guzman at the end of the visit.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Paola Guerrero
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2