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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336409060
Report Date: 03/03/2026
Date Signed: 03/03/2026 12:31:39 PM

Substantiated


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
02/25/2026 and conducted by Evaluator Mary Rico
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20260225122758
FACILITY NAME:INSPIRATIONS HOME CARE IIIFACILITY NUMBER:
336409060
ADMINISTRATOR:GARCIA, NOELIAFACILITY TYPE:
740
ADDRESS:2685 COTTAGE DRTELEPHONE:
(951) 898-8431
CITY:CORONASTATE: CAZIP CODE:
92881
CAPACITY:6CENSUS: 5DATE:
03/03/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:House Manager - Rose MacdangdangTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Staff are overmedicating resident in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to investigate and deliver the findings on the allegation listed above. LPA met with House Manager Rose Mary Macdangdang and explained the purpose of today’s visit. The Licensee was also contacted and informed regarding today’s visit.
The investigation consisted of staff interviews, resident interviews and record review.

For the allegation, Staff are overmedicating resident in care. During medication audit, LPA Rico observed 1 lose pill in R1 medication bin and 1 lose pill in R2 medication bin. In addition, R1 PRN medication was documented as given but did not include the reason and result. R2 medication was documented as given but the medication was still on the bubble pack. During staff interviews, 1 out of the 2 staff admitted they had made medication errors. During resident interviews, 1 out of the 3 residents stated that staff will sometimes forget to provide medication.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2026
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 5
Control Number 56-AS-20260225122758
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: INSPIRATIONS HOME CARE III
FACILITY NUMBER: 336409060
VISIT DATE: 03/03/2026
NARRATIVE
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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 allegations are valid because of the preponderance of evidence the standard has been met. During today’s visit, one (1) 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 Rose Macdangdang, along with a copy of the appeal rights.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
02/25/2026 and conducted by Evaluator Mary Rico
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20260225122758

FACILITY NAME:INSPIRATIONS HOME CARE IIIFACILITY NUMBER:
336409060
ADMINISTRATOR:GARCIA, NOELIAFACILITY TYPE:
740
ADDRESS:2685 COTTAGE DRTELEPHONE:
(951) 898-8431
CITY:CORONASTATE: CAZIP CODE:
92881
CAPACITY:6CENSUS: 5DATE:
03/03/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:House Manager - Rose MacdangdangTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Staff do not provide adequate care and supervision to resident in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mary Rico conducted an unannounced visit to investigate and deliver the findings on the allegation listed above. LPA met with House Manager Rose Mary Macdangdang and explained the purpose of today’s visit. The Licensee was also contacted and informed regarding today’s visit. The investigation consisted of staff interviews, resident interviews and record review.

For the allegation, Staff do not provide adequate care and supervision to residents in care. During resident interviews 2 out of the 3 residents stated adequate care and supervision is provided. 1 out of the 3 residents was unable to collaborate on the allegation. During staff interviews, 3 out of the 3 staff stated adequate care and supervision is provided to residents.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 56-AS-20260225122758
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: INSPIRATIONS HOME CARE III
FACILITY NUMBER: 336409060
VISIT DATE: 03/03/2026
NARRATIVE
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Based on the evidence found during the investigation, the one (1) allegation 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 House Manager Rose Mary Macdangdang
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 56-AS-20260225122758
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: INSPIRATIONS HOME CARE III
FACILITY NUMBER: 336409060
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/03/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/04/2026
Section Cited
CCR
87465(d)(3)
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87465 Incidental Medical and Dental Care (d)(3)The date and time the PRN medication was taken, the dosage taken, and the resident's response shall be documented and maintained in the resident's facility record.
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The Licensee stated they will conduct an in-service training for medication and will send a copy to LPA Rico.
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Based on record review , the licensee did not comply with the section cited above having medication errors on R1 and R1 PRN medications which poses an immediate health, safety or personal rights risk to persons in care.
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POC 3/4/2026.
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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.
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Mary Rico
LICENSING EVALUATOR SIGNATURE:

DATE: 03/03/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/03/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5