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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 335530163
Report Date: 07/20/2026
Date Signed: 07/20/2026 02:02:25 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
06/15/2026 and conducted by Evaluator Beena Singh
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20260615140640
FACILITY NAME:COMFORT SENIOR VILLAFACILITY NUMBER:
335530163
ADMINISTRATOR:AGUINALDO, KRISTENFACILITY TYPE:
740
ADDRESS:3133 SONRISA DRIVETELEPHONE:
(951) 547-4900
CITY:CORONASTATE: CAZIP CODE:
92881
CAPACITY:6CENSUS: 4DATE:
07/20/2026
UNANNOUNCEDTIME BEGAN:
12:50 PM
MET WITH:Facility Administrator, Mya AguinaldoTIME COMPLETED:
02:20 PM
ALLEGATION(S):
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9
Staff refused to change the resident’s diaper for several days.
Staff spoke inappropriately to resident in care.
Staff refused to provide water to resident in care.
INVESTIGATION FINDINGS:
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2
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Licensing Program Analyst (LPA) Beena Singh conducted an unannounced visit to the facility to deliver findings to the above complaint investigation. LPA met with a Administrator, Mya Aguinaldo, and explained the purpose of the visit.
The Department’s investigation consisted of an unannounced facility visit, records review, and staff and residents interviews.

First Allegation:-Staff refused to change the resident’s diaper for several days.
LPA Singh conducted review of records and interviewed residents.
According to staff and Four(4) out of Four(4) residents stated that staff always assist them and never refuse to assist for continence needs of the residents and always are kind and helpful. R#1 has moved out of the facility on June 11th, 2026.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2026
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-20260615140640
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: COMFORT SENIOR VILLA
FACILITY NUMBER: 335530163
VISIT DATE: 07/20/2026
NARRATIVE
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Second Allegation:-Staff spoke inappropriately to resident in care.
Staff and Four(4) out of Four(4) residents stated During the review, every staff member and all four residents said that the caregivers are always kind and helpful. The residents shared that the staff are always polite and never say anything mean or inappropriate. According to residents Staff creates a safe, friendly, and respectful home for everyone living there.

Third Allegation:-Staff refused to provide water to resident in care
LPA Singh conducted review of records and interviewed residents.
According to staff and Four(4) out of Four(4) residents stated that staff always provide water to resident in care and never refuse providing care and supervision.

Based on interviews and record review, the investigation did not yield a preponderance of evidence to conclude Staff refused to change the resident’s diaper for several days, Staff spoke inappropriately to resident in care and Staff refused to provide water to resident in care.

Based on the evidence found during the investigation, the allegations listed above Staff refused to change the resident’s diaper for several days, Staff spoke inappropriately to resident in care and Staff refused to provide water to resident in care are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur. 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 copy of LIC9099 were provided to Administrator Mya Aquinaldo.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2026
LIC9099 (FAS) - (06/04)
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