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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 361881195
Report Date: 05/27/2026
Date Signed: 06/08/2026 01:01:48 PM

Unsubstantiated


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
02/14/2024 and conducted by Evaluator Eldin Serrano
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20240214154635
FACILITY NAME:PALM VIEW PLEASANT LIVINGFACILITY NUMBER:
361881195
ADMINISTRATOR:KARA RICHARDSONFACILITY TYPE:
740
ADDRESS:710 N CHURCH STREETTELEPHONE:
(909) 328-2118
CITY:REDLANDSSTATE: CAZIP CODE:
92374
CAPACITY:40CENSUS: 33DATE:
05/27/2026
UNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Delcie Mucha, AdministratorTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Staff did not provide resident with appropriate mattress resulting in resident sustaining pressure injures
Staff did not properly monitor resident's catheter
Staff did not seek timely medical attention for resident
INVESTIGATION FINDINGS:
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On 5/27//2026 at 8:55 AM, Licensing Program Analyst (LPA) Eldin Serrano made an unannounced visit to the facility to investigate and deliver the findings of the above allegations. LPA Serrano met with administrator Delcie Mucha to explain the purpose of the visit. The investigation consisted of interviews with facility staff, outside parties, and a hospice agency, as well as review of resident records, hospice documents and physician orders.

Allegation #1: Staff did not provide resident with appropriate mattress resulting in resident sustaining pressure injures: Interviews revealed that the air mattress in question was ordered, delivered, and managed by the resident's hospice agency, not the facility. Staff reported that the mattress was delivered by hospice personnel and that facility staff sought assistance from hospice when concerns arose regarding the mattress. Documentation and interviews confirmed that hospice was responsible for resident #1’s (R1) specialized medical equipment and wound care. Records review and interviews showed that facility staff notified hospice regarding concerns about the R1 developing pressure injury. There is not sufficient evidence to corroborate that facility staff failed to provide an appropriate mattress or that staff actions caused the resident's condition. Therefore, the allegation is Unsubstantiated, meaning that although the allegation may have happened or may be valid, there is insufficient evidence to prove the allegation occoured.

*** Continuation in LIC9099C ***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Eldin Serrano
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2026
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 56-AS-20240214154635
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: PALM VIEW PLEASANT LIVING
FACILITY NUMBER: 361881195
VISIT DATE: 05/27/2026
NARRATIVE
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 Allegation #2: Staff did not properly monitor the resident's catheter. - Based on interviews conducted and a review of facility and hospice records, it was determined that catheter care and monitoring were the responsibility of the resident's hospice provider. Documentation reviewed, including physician's orders and hospice records, confirmed that hospice personnel were responsible for catheter-related services. Interviews with facility staff indicated that they followed the directions provided by the hospice agency and notified hospice when concerns arose regarding the resident's catheter. The investigation did not reveal evidence that facility staff failed to provide services within their scope of responsibility or failed to follow the resident’s care plan. Therefore, there is insufficient evidence to support the allegation, and the allegation is determined to be unsubstantiated.

Allegation #3: Staff did not seek timely medical attention for a resident - Based on interviews conducted with facility staff, outside parties and a review of records, it was revealed that facility staff contacted the hospice agency promptly upon observing that R1 developed a pressure wound. R1 was receiving care from the hospice agency. Therefore, the allegation is unsubstantiated.

Based on the evidence, review of records and interviews, the allegations mentioned above are UNSUBSTANTIATED. A finding that the complaint is UNSUBSTANTIATED means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated at this time.


An exit interview was conducted where this report, LIC9099 and LIC9099C were discussed and provided to Administrator Delcie Mucha.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Eldin Serrano
LICENSING EVALUATOR SIGNATURE:

DATE: 05/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2