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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336425396
Report Date: 08/12/2026
Date Signed: 08/12/2026 02:39:21 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
06/24/2026 and conducted by Evaluator Raquel Hernandez
COMPLAINT CONTROL NUMBER: 56-AS-20260624141657
FACILITY NAME:ROYAL PALMS GUEST HOMEFACILITY NUMBER:
336425396
ADMINISTRATOR:ARNALINA JAUDALSOFACILITY TYPE:
740
ADDRESS:6943 GYPSUM CREEK DRVTELEPHONE:
(951) 427-3516
CITY:EASTVALESTATE: CAZIP CODE:
92880
CAPACITY:6CENSUS: 2DATE:
08/12/2026
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:House Manager Marco PascaranTIME COMPLETED:
02:50 PM
ALLEGATION(S):
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Staff did not follow reporting requirements
INVESTIGATION FINDINGS:
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On 08/12/2026 Licensing Program Analyst (LPA) Raquel Hernandez conducted an unannounced visit to deliver findings for above allegations. LPA met with House Manager Marco Pascaran and explained the purpose of today's visit.

On 06/26/2026, the licensing department received a complaint with five (5) allegations. One allegation is indicating staff did not follow reporting requirements. LPA discovered facility's air conditioner stopped working on 06/16/2026 approximately. LPA observed facility did not report this to licensing department. Based on the evidence gathered during today’s investigation, the one (1) allegation listed above are deemed SUBSTANTIATED. A finding that the complaints are SUBSTANTIATED means that the allegation are valid because the preponderance of evidence the standard has been met. During today’s visit, a deficiency was cited per Title 22, Division 6, of the California Code of Regulations. An exit interview was conducted, and this report (LIC9099) and (LIC9099D) was discussed and provided to House Manager Marco Pascaran along with a copy of the appeal rights.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2026
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 3
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
06/24/2026 and conducted by Evaluator Raquel Hernandez
COMPLAINT CONTROL NUMBER: 56-AS-20260624141657

FACILITY NAME:ROYAL PALMS GUEST HOMEFACILITY NUMBER:
336425396
ADMINISTRATOR:ARNALINA JAUDALSOFACILITY TYPE:
740
ADDRESS:6943 GYPSUM CREEK DRVTELEPHONE:
(951) 427-3516
CITY:EASTVALESTATE:CAZIP CODE:
92880
CAPACITY:6CENSUS: 2DATE:
08/12/2026
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:House Manager Marco PascaranTIME COMPLETED:
02:50 PM
ALLEGATION(S):
1
2
3
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5
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8
9
Staff hit resident in care
Staff spoke inappropriately to resident in care
Facility air conditioner is in disrepair
INVESTIGATION FINDINGS:
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Additionally, it is being alleged staff hit resident in care and staff spoke inappropriately to resident in care. Per interviews, LPA did not corroborate enough evidence to prove that the alleged violations may have or may have not occured. Furthermore, it has being alleged facility air conditioner is in disrepair. LPA discovered air conditioner broke down approximately on 06/16/2026. LPA observed facility staff did purchase portable air conditioner for both residents in care and placed portable units in each residents room. Facility staff have purchase a new air conditioner system for the facility. Based on the evidence gathered during today’s investigation, the allegation listed above are deemed UNSUBSTANTIATED. A finding that the complaints are UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred. An exit interview was conducted and this report (LIC9099) along with other forms were discussed and provided to House Manager Marco Pascaran.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2026
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-20260624141657
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: ROYAL PALMS GUEST HOME
FACILITY NUMBER: 336425396
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/19/2026
Section Cited
CCR
87211(a)(1)(D)
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(a) Each licensee shall furnish to the licensing agency... (1) A written report shall be submitted to the licensing agency and to the person responsible for the resident within seven days...(D) Any incident which threatens the welfare, safety or health of any resident...
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Licensee stated moving forward to submit all special incident reports (SIR) that regard residents personal, health, and or safety risks to licensing department within seven days of occurence.
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Based on observation and interviews, the licensee did not comply with section cited above by not ensuring facility reported air conditioner breaking to licensing department within seven days of occurence, which poses a potential health, safety, and or 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.
SUPERVISOR'S NAME: Efren Malagon
LICENSING EVALUATOR NAME: Raquel Hernandez
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3