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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366423704
Report Date: 02/11/2026
Date Signed: 02/11/2026 01:11:00 PM

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
03/01/2024 and conducted by Evaluator Magda Malcore
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240301121823
FACILITY NAME:AASPEN VILLAGECARE IIFACILITY NUMBER:
366423704
ADMINISTRATOR:MUSHTAQ KHANFACILITY TYPE:
740
ADDRESS:7645 KICKAPOO TRAILTELEPHONE:
(760) 365-6338
CITY:YUCCA VALLEYSTATE: CAZIP CODE:
92284
CAPACITY:15CENSUS: 2DATE:
02/11/2026
UNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Amanda RobertsTIME COMPLETED:
01:20 PM
ALLEGATION(S):
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Facility staff prevented resident from seeing physician of choice
Facility staff did not ensure resident had appropriate clothing
Facility staff did not assist resident with transferring to wheelchair
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced visit to the facility to conclude the complaint investigation and deliver findings on the above allegations. LPA met with House Manager, Amanda Roberts, who was informed of today’s visit. The investigation consisted of LPA observations, reviewing pertinent records, and interviews with relevant parties.

Regarding the allegation, facility staff prevented resident from seeing physician of choice, there is not enough evidence to corroborate this allegation. Interview with resident #1(R1) indicates that staff did not prevent them from seeing a physician of their choice. Interviews with five (5) staff indicate that they did not prevent R1 from seeing a physician of choice.

Regarding the allegation, facility staff did not ensure resident had appropriate clothing, there is not enough evidence to corroborate this allegation. Interview with (R1) indicates that they had appropriate clothing to wear. Interviews with five (5) staff indicate that they did ensure R1 had appropriate clothing.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026
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 6
Control Number 56-AS-20240301121823
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: AASPEN VILLAGECARE II
FACILITY NUMBER: 366423704
VISIT DATE: 02/11/2026
NARRATIVE
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Regarding the allegation, facility staff did not assist resident with transferring to wheelchair, interviews with three (3) residents and five (5) staff indicate there is not a preponderance of evidence to corroborate the allegation that staff did not assist resident with transferring.

Based on the Department’s investigation, the above allegations are Unsubstantiated. A finding that a complaint is Unsubstantiated means that although the allegation(s) may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur.

An exit interview was conducted where reports (LIC 9099 & LIC9099C) were discussed, and a copy was provided to House Manager Roberts at the conclusion of the visit.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 6
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
03/01/2024 and conducted by Evaluator Magda Malcore
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240301121823

FACILITY NAME:AASPEN VILLAGECARE IIFACILITY NUMBER:
366423704
ADMINISTRATOR:MUSHTAQ KHANFACILITY TYPE:
740
ADDRESS:7645 KICKAPOO TRAILTELEPHONE:
(760) 365-6338
CITY:YUCCA VALLEYSTATE: CAZIP CODE:
92284
CAPACITY:15CENSUS: 2DATE:
02/11/2026
UNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Amanda RobertsTIME COMPLETED:
01:20 PM
ALLEGATION(S):
1
2
3
4
5
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7
8
9
Facility staff prevented resident from having visitors
Facility staff prevented resident from receiving phone calls
INVESTIGATION FINDINGS:
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2
3
4
5
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7
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9
10
11
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13
Licensing Program Analyst (LPA) Magda Malcore conducted an unannounced visit to the facility to conclude the complaint investigation and deliver findings on the above allegations. LPA met with House Manager, Amanda Roberts, who was informed of today’s visit. The investigation consisted of LPA reviewing pertinent records, and interviews with relevant parties.

Regarding the allegation, facility staff prevented resident from having visitors and the allegation that staff prevented resident from receiving phone calls, LPA record review, interviews with outside parties, resident #1(R1), and five (5) staff indicate that staff did prevent resident from having visitors and receiving phone calls at the facility. Staff interviews revealed that they prevented R1 from receiving visitors and phone calls from certain family members at the request of R1’s authorized representative with power of attorney. A review of the power of attorney document provided by facility staff revealed that there is no explicit specification in the document restricting R1 from receiving calls or having visitors. An interview with R1 revealed that there were no family members whom she did not wish to visit or speak with.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 56-AS-20240301121823
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: AASPEN VILLAGECARE II
FACILITY NUMBER: 366423704
VISIT DATE: 02/11/2026
NARRATIVE
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Based on the Department’s investigation, the allegations that facility staff prevented resident from having visitors and prevented resident from receiving phone calls is Substantiated. A finding that the complaint is Substantiated means that the allegation(s) is valid because the preponderance of the evidence standard has been met.

An exit interview was conducted where reports (LIC9099, LIC9099C, LIC9099-D) were discussed and provided with appeal rights to House Manager Roberts at the conclusion of the visit
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 56-AS-20240301121823
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: AASPEN VILLAGECARE II
FACILITY NUMBER: 366423704
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/18/2026
Section Cited
CCR
87468.2(a)(21)
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87468.2(a)In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents...shall have all of the following personal rights:(21)To consent to have their relatives and other individuals of their choosing visit during reasonable hours, privately, and without prior notice. This requirement is not met at evidenced by:
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The Licensee/Administrator has agreed to provide staff with inservice training on the regulation cited and submit documentation of training to the licensing agency by POC due date.
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The licensee did not comply with the section cited above by staff restricting R1’s visits without consent from resident, which poses a potential health, safety, and personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 56-AS-20240301121823
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: AASPEN VILLAGECARE II
FACILITY NUMBER: 366423704
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/18/2026
Section Cited
HSC
87468.1(a)(14)
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87468.1(a)Residents in all residential care facilities for the elderly shall have all of the following personal rights:(14) To have reasonable access to telephones, to both make and receive confidential calls. This requirement is not met as evidenced by:
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The Licensee/Administrator has agreed to provide staff with inservice training on the regulation cited and submit documentation of training to the licensing agency by POC due date.
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The Licensee did not comply with the section cited above by facility staff restricting R1’s telephone calls without resident’s consent, which poses a potential health, safety, and personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2026
LIC9099 (FAS) - (06/04)
Page: 6 of 6