366402583-10-29-2025-56-AS-EMAN-DPETVX-20251216140439

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 366402583
Report Date: 10/29/2025
Date Signed: 10/29/2025 02:26:54 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 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
10/09/2025 and conducted by Evaluator Raquel Hernandez

COMPLAINT CONTROL NUMBER: 56-AS-20251009094016

FACILITY NAME:	BROOKDALE NORTH EUCLID		FACILITY NUMBER:	366402583
ADMINISTRATOR:	LISA TO		FACILITY TYPE:	740
ADDRESS:	1031 N EUCLID AVE		TELEPHONE:	(909) 391-2622
CITY:	ONTARIO	STATE: CA	ZIP CODE:	91762
CAPACITY:	140	CENSUS: 71	DATE:	10/29/2025
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Administrator Logan Harrison		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff are not meeting resident's hygiene needs.
Staff are not meeting resident's toileting needs.
Resident is left in soiled diapers for extended periods of time.
Staff do not ensure that resident's room is clean.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Raquel Hernandez conducted an unannounced visit for the purpose of deliever findings for the above allegations. LPA met with Administrator Logan Harrison and explained today's visit.

For the allegation, Staff are not meeting resident's hygiene needs.

LPA conducted (8) resident interviews. 7 out of the 8 stated facility staff do help with residents with hygeine needs. Resident #1 (R1), Resident #2 (R2) and Resident #6 (R6) stated facility staff do assist with showering and brushing teeth as needed. LPA conducted (6) staff interviews. 6 out of the 6 staff stated residents are assisted with hygeine needs such as bathing, showering, and teeth brushing when needed. 6 Additionally, 5 out of the 6 staff stated some residents may refuse hygeine services, such as bathing or teeth brushing. LPA observed facility shower schedule.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 56-AS-20251009094016

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BERNARDINO ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: BROOKDALE NORTH EUCLID	FACILITY NUMBER: 366402583
	VISIT DATE: 10/29/2025

NARRATIVE

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For the allegation, Staff are not meeting resident's toileting needs.

LPA conducted (8) resident interviews. 7 out of the 8 stated facility staff does meet residents toileting needs. LPA conducted (6) staff interviews. 6 out of the 6 stated facility staff do assist with toileting needs and room checks are conducted throughout the day to check on residents in care and assist with any toileting needs.

For the allegation, Resident is left in soiled diapers for extended periods of time.

LPA conducted (8) resident interviews. 3 out of the 8 residents required use of diapers. 2 out of the 3 stated facility staff do not leave residents in soiled diapers for extended periods of time. LPA conducted (6) staff interviews. 6 out of the 6 staff stated facility staff will change residents diapers in a timely manner and have not witnessed residents being left in soiled diapers for extended amount of time.

For the allegation, Staff do not ensure that resident's room is clean.

LPA conducted (8) resident interviews. 8 out of the 8 residents stated facility staff do ensure residents rooms are kept clean and are on a cleaning schedule weekly. LPA conducted (6) staff interviews. 6 out of the 6 stated residents rooms are kept clean and have a weekly schedule for each resident's room.

Based on the evidence gathered during today’s investigation, the allegations listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

During today’s visit, no deficiencies were cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC9099) (LIC9099C) was discussed and provided to Administrator Logan Harrison.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/29/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/29/2025

LIC9099 (FAS) - (06/04)

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