<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 365530259
Report Date: 09/04/2026
Date Signed: 09/04/2026 09:53:51 AM

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
06/15/2026 and conducted by Evaluator Edith Conchas
COMPLAINT CONTROL NUMBER: 56-AS-20260615114057
FACILITY NAME:HILLS OF SOUTH LANE II, THEFACILITY NUMBER:
365530259
ADMINISTRATOR:CHAVEZ, REGINAFACILITY TYPE:
740
ADDRESS:12908 SOUTH LANETELEPHONE:
(714) 363-3752
CITY:REDLANDSSTATE: CAZIP CODE:
92373
CAPACITY:6CENSUS: 0DATE:
09/04/2026
ANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Owner, Allen Medina TIME COMPLETED:
10:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility illegally evicted residents in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 9/4/2026, Licensing Program Analysts (LPA's) Edith Conchas, Matthew Aguilar and Leslie Mendiveles conducted an announced visit at the rengional office to conclude the investigation and provide the findings for the above mentioned complaint. LPA met with Allen Medina. The investigation consisted of interviews with relevant parties and record review.

Allegation Facility illegally evicted residents in care.
Interview with RP (RP), Witness 1 (W1), and Witness 2 (W2) all stated that the facility did not provide written eviction notices and residents were directed to relocate without proper notice. Record review revealed an email chain between family members and facility staff regarding relocation concerns. LPA did not observe the email to include a formal written eviction notice as required under Title 22. Interview with Staff 1 (S1) stated that the sheriff’s department served an eviction notice to the facility on June 12th, 2026, and that the facility lost control of the property on June 24, 2026. Staff 1 confirmed all residents had vacated prior to LPA’s visit on June 24th, 2026. RP reported R3 move out on June 25, 2026.

Continue to LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Edith Conchas
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2026
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
Control Number 56-AS-20260615114057
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: HILLS OF SOUTH LANE II, THE
FACILITY NUMBER: 365530259
VISIT DATE: 09/04/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Based on the evidence gathered, the allegation is Substantiated. A substantiated findings means the allegation is valid because the preponderance of the evidence standard has been met.
During today’s visit, deficiencies were issued. An exit interview was conducted, and this report and appeal rights were discussed and provided to Facility owner Allen Medina.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Edith Conchas
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 56-AS-20260615114057
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: HILLS OF SOUTH LANE II, THE
FACILITY NUMBER: 365530259
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/04/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/08/2026
Section Cited
CCR
87224
1
2
3
4
5
6
7
(a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5). Thirty (30) days written notice to the resident is required except as otherwise specified in paragraph (5). This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee stated that he will provide an acknowledment confirming that he will adhere to and comply with eviction procedures> Licensee will submit wirtten documentaion by POC date.
8
9
10
11
12
13
14
Based on observation, interview and record review, the licensee did not comply with the section cited above by not generating a closure letter and submitting it to CCLD, Licensee did not surrender the facility, license and 3) did not provide a written letter within the time required to the residents in care which poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Karen Clemons
LICENSING EVALUATOR NAME: Edith Conchas
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3