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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336426776
Report Date: 09/22/2026
Date Signed: 09/22/2026 12:23:28 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE 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
09/17/2026 and conducted by Evaluator Toni Nwala
COMPLAINT CONTROL NUMBER: 18-AS-20260917130033
FACILITY NAME:BELLA CASA 2FACILITY NUMBER:
336426776
ADMINISTRATOR:CARLOS, ROMMELFACILITY TYPE:
740
ADDRESS:77-632 BARONS CIRTELEPHONE:
(760) 772-5089
CITY:PALM DESERTSTATE: CAZIP CODE:
92211
CAPACITY:6CENSUS: 6DATE:
09/22/2026
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Ula CarlosTIME COMPLETED:
12:40 PM
ALLEGATION(S):
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Facility staff did not allow resident to have a visitor during reasonable hours
Residents health deteriorated due to staff neglect
INVESTIGATION FINDINGS:
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On September 22, 2026 Licensing Program Analyst, (LPA) Toni Nwala arrived unannounced at the facility to initiate an investigation into the allegations listed above. LPA met with Licensee Ula and Rommel Carlos and explained the purpose of the visit.

On September 17, 2026, Community Care Licensing received a complaint alleging Facility staff did not allow resident to have a visitor during reasonable hours and Residents health deteriorated due to staff neglect. LPA conducted interviews with Licensee staff and residents. LPA also conducted a review of pertinent documentation.

In regard to the allegation that residents health deteriorated due to staff neglect, it is reported that Resident #1 (R1) health has been decling since 2004, before R1 arrived to the facility.
(Continued on LIC9099-C, page 2)
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Toni Nwala
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026
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 2
Control Number 18-AS-20260917130033
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: BELLA CASA 2
FACILITY NUMBER: 336426776
VISIT DATE: 09/22/2026
NARRATIVE
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Continued from LIC9099, page 1)

In regard to the allegation facility staff did not allow resident to have a visitor during reasonable hours , it is reported R1 can have visitors however R1, Power of Attorney (POA) have a three year restraining order against certain members of the family. And those family members are not allowed to the facility without consent from the POA



Based on staff interviews, resident interviews, facility records, the allegations Facility staff did not allow resident to have a visitor during reasonable hours and Residents health deteriorated due to staff neglect; it was revealed that there are current family dynamics. We have found that the complaint was unfounded, meaning that the allegations were false, could not have happened and/or are without a reasonable basis.

An exit interview was conducted with Ula and Rommel Carlos, and a copy of this report was provided along
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Toni Nwala
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2