<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366425833
Report Date: 03/27/2025
Date Signed: 03/27/2025 05:07:21 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
03/25/2025 and conducted by Evaluator Magda Malcore
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20250325121813
FACILITY NAME:SILVERCARE HOMESFACILITY NUMBER:
366425833
ADMINISTRATOR:ROLANDO/ZENAIDA SERQUINIAFACILITY TYPE:
740
ADDRESS:25117 LAWTON AVENUETELEPHONE:
(909) 796-1223
CITY:LOMA LINDASTATE: CAZIP CODE:
92354
CAPACITY:6CENSUS: 5DATE:
03/27/2025
UNANNOUNCEDTIME BEGAN:
03:35 PM
MET WITH:Rolando SerquiniaTIME COMPLETED:
05:10 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not following general food requirements
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a complaint investigation on the above complaint allegation. LPA met with Administrator, Rolando Serquinia, and discussed the purpose of the visit.

Regarding the allegation, staff are not following general food requirements, LPA observed the facility maintained nonperishable foods for minimum of one week and perishable foods for a minimum of two days. Three (3) residents interviews reveal they are being provided breakfast, lunch, dinner and snacks.

Based observations and interviews, the above allegation is Unsubstantiated. 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 and a copy of this report was provided to Administrator Serquinia at the conclusion of the visit.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 03/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2025
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 3
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
03/25/2025 and conducted by Evaluator Magda Malcore
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20250325121813

FACILITY NAME:SILVERCARE HOMESFACILITY NUMBER:
366425833
ADMINISTRATOR:ROLANDO/ZENAIDA SERQUINIAFACILITY TYPE:
740
ADDRESS:25117 LAWTON AVENUETELEPHONE:
(909) 796-1223
CITY:LOMA LINDASTATE: CAZIP CODE:
92354
CAPACITY:6CENSUS: 5DATE:
03/27/2025
UNANNOUNCEDTIME BEGAN:
03:35 PM
MET WITH:Rolando SerquiniaTIME COMPLETED:
05:10 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not keep the facility free from disrepairs
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Magda Malcore made an unannounced visit to the facility to conduct a complaint investigation on the above complaint allegation. LPA met with Administrator, Rolando Serquinia, and discussed the purpose of the visit.

Regarding the allegation, staff do not keep the facility free from disrepairs, it was alleged the facility's washing machine was not working and the front window of the facility was broken. LPA observed the washing machine was operating properly; However, the front window was observed broken. The Licensee stated that a maintenance person will be at the facility to repair the broken window on Saturday.

Based on observations and interviews, the allegation is Substantiated. Substantiated meaning that the allegation(s) is valid because the preponderance of the evidence standard has been met.
An exit interview was conducted where reports (LIC9099&LIC9099-D) were discussed and provided with appeal rights to Licensee Serquinia at the conclusion of the visit.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Magda Malcore
LICENSING EVALUATOR SIGNATURE:

DATE: 03/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 56-AS-20250325121813
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: SILVERCARE HOMES
FACILITY NUMBER: 366425833
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/27/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/31/2025
Section Cited
CCR
87303(a)
1
2
3
4
5
6
7
87303(a)The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors..this requirement is not met as evidenced by:
1
2
3
4
5
6
7
The licensee stated that the broken window will be repaired on Saturday 3/29/2025. The Licensee shall submit proof of repairs to the licensing agency by POC due date.
8
9
10
11
12
13
14
The Licensee did not comply with the section cited above by not ensuring the broken front window was repaired; which poses a potential health, safety, and personal rights risk to persons in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: 03/27/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3