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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366405789
Report Date: 12/14/2021
Date Signed: 09/04/2025 12:47:30 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
12/13/2021 and conducted by Evaluator Javier Prieto
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20211213093806
FACILITY NAME:GOLDEN GUEST HOMEFACILITY NUMBER:
366405789
ADMINISTRATOR:GALASINAO, ADELAIDAFACILITY TYPE:
740
ADDRESS:25070 DAISY AVENUETELEPHONE:
(909) 796-0882
CITY:LOMA LINDASTATE: CAZIP CODE:
92354
CAPACITY:6CENSUS: 4DATE:
12/14/2021
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Adelaida Galasinao, AdministratorTIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is unsanitary.
Resident's hygiene needs not being met.
Covid-19 screening protocols not being followed.
Covid-19 masking protocols not being followed.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a complaint investigation regarding the above allegations. LPA Prieto met with licensee Adelaida Galasinao and explained the elements of the complaint.

Allegation #1 - LPA observed facility to be clean and sanitary.

Allegation #2 - LPA interviewed resident #1 (R1), R2, R3 all state their hygene needs are met.

Allegation #3 - LPA was greeted by facility staff, who was wearing a mask, and took LPA's temperature and signed in visitor's log sheet. Facility has sufficient amount of sanitation gels and disinfecting wipes throughout the facility.

Allegation #4 - All staff at the facility were following COVID protocol by wearing masks at the facility.

Based on the information obtained there is not enough evidence to support the allegations in this complaint. Therefore, the allegations are deemed UNSUBSTANTIATED at this time. This report was signed by LPA Prieto and Administrator Galasinao and a copy was left at the facility.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 12/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/14/2021
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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