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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366425833
Report Date: 08/13/2025
Date Signed: 08/13/2025 03:35:55 PM

Substantiated


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
08/07/2025 and conducted by Evaluator Becky Mann
COMPLAINT CONTROL NUMBER: 56-AS-20250807171708
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:
08/13/2025
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Rolando Serquinia, AdministratorTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Licensee is not keeping the facility free from pests
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Becky Mann conducted an unannounced visit to the facility to initiate a complaint investigation. LPA met with Rolando Serquinia, Administrator and explained the purpose of the visit. The investigation consisted of LPA pertinent record reviews, observations and interviews with staff.

The allegation that Licensee is not keeping the facility free from pests. Interview with staff revealed that the facility has had an ongoing issue with roaches for a few months. Based on LPA observations, roach excrements were found behind the refrigerator, pantry, and kitchen cabinets. LPA also observed a small size live roach on the top of the fridge door.

Based on observations, interviews, and record reviews, the allegation is SUBSTANTIATED. A finding that the complaint is SUBSTANTIATED means that the allegation is valid because the preponderance of the evidence standard has been met. During today’s visit, a deficiency was cited and an exit interview was conducted, and this report LIC9099, LIC9099D and appeal rights were discussed and provided to Rolando, Administrator.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nedra Brown
LICENSING EVALUATOR NAME: Becky Mann
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025
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-20250807171708
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: SILVERCARE HOMES
FACILITY NUMBER: 366425833
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/13/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/20/2025
Section Cited
CCR
80087(a)(1)
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80087(a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. (1).. licensee shall...keep the facility free of flies and other insects. This requirement is not met as evidenced by:
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Administrator stated that they will conduct a thorough cleaning of facility to remove all pest excrements. Obtain a professional pest control service purchase to eliminate the pest. Send pictures of cleaning and invoice to LPA via email by POC due date.
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Based on LPA observations, interviews, and record reviews the administrator did not keep the facility clean and enforce the pest control service which allowed pest to become an ongoing issue which poses a potential health, safety and personal 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: Nedra Brown
LICENSING EVALUATOR NAME: Becky Mann
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2