365530196-9-18-2026-56-AS-EMAN-DY9VZ5-20260925165210

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 365530196
Report Date: 09/18/2026
Date Signed: 09/18/2026 02:35:57 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
09/10/2026 and conducted by Evaluator Mary Rico

PUBLIC

COMPLAINT CONTROL NUMBER: 56-AS-20260910123804

FACILITY NAME:	TREE OF LIFE CARE HOME		FACILITY NUMBER:	365530196
ADMINISTRATOR:	RAJPOOT, BILAL		FACILITY TYPE:	740
ADDRESS:	1652 VIA SEVILLA ST		TELEPHONE:	(951) 444-9993
CITY:	CORONA	STATE: CA	ZIP CODE:	92881
CAPACITY:	6	CENSUS: 5	DATE:	09/18/2026
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Licensee Alia Rajpoot		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff do not ensure resident is provided pain medication as needed.
Staff mishandled residents medications.

INVESTIGATION FINDINGS:

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On 9/18/2026 Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to investigate and deliver findings on the allegations listed above. LPA met with Licensee Alia Rajpootand explained the purpose of the visit. The investigation consisted of staff interviews, resident interviews, and record review.

For the allegation, staff do not ensure resident is provided pain medication as needed. During staff interviews three out of three staff stated that all residents receive their medication, including as needed medication. During resident interviews, three out of the three residents were unable to collaborate on allegation. During record review, LPA observed R1 primary physician had discharged all as needed medication.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2026

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-20260910123804

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: TREE OF LIFE CARE HOME	FACILITY NUMBER: 365530196
	VISIT DATE: 09/18/2026

NARRATIVE

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For the allegation, staff mishandled resident medication. During staff interviews three out of three stated that resident’s medication is not being mishandled. Staff also indicated medication is dispensed by physician orders. During resident interviews, three out of the three residents were unable to collaborate on the allegation. During record review, LPA observed medication to be dispensed and document properly.

Based on the evidence found during the investigation, the two allegations listed above 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 this report (LIC9099) was discussed and provided to Licensee Alia Rajpoot.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2026

LIC9099 (FAS) - (06/04)

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