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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366426081
Report Date: 04/08/2026
Date Signed: 04/08/2026 10:28:14 AM

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
04/01/2026 and conducted by Evaluator Beena Singh
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20260401171111
FACILITY NAME:COMFORT HOME 2FACILITY NUMBER:
366426081
ADMINISTRATOR:LAL, HARISH K.FACILITY TYPE:
740
ADDRESS:7092 PROVIDENCE WAYTELEPHONE:
(909) 371-3427
CITY:FONTANASTATE: CAZIP CODE:
92336
CAPACITY:6CENSUS: 6DATE:
04/08/2026
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Facility Staff-Anayeli Hoyos TIME COMPLETED:
10:40 AM
ALLEGATION(S):
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Facility has mold.
INVESTIGATION FINDINGS:
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On04/08/2026, Licensing Program Analyst (LPA) Beena Singh conducted an unannounced visit to initiate and deliver findings on the allegation listed above. LPA was greeted by Facility Staff Anayeli Hoyos and granted entry to the facility and explained the purpose of the visit. The investigation consisted of interviews, observations, and review of records.

First Allegation:-Facility has mold.
During a facility walk-through conducted by Licensing Program Analyst (LPA) Singh, no evidence of mold was observed on walls or within any interior areas, including the kitchen and hallways. This finding was supported by interviews with two staff members and four residents, Two(2) out of two (2) staff and four(4) out of four(4) residents, all of whom reported no sightings of mold or unusual odors on the premises. While the licensee has proactively replaced the kitchen sink countertop and is currently renovating a resident bathroom, an inspection of a recently replaced bedroom ceiling, revealed no signs of water intrusion, mold growth, or unusual odors.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2026
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-20260401171111
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: COMFORT HOME 2
FACILITY NUMBER: 366426081
VISIT DATE: 04/08/2026
NARRATIVE
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Based on the evidence found during the investigation, the allegation listed facility has mold is 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, signed and provided to Staff/Caregiver Anayeli Hoyos facility representative at the conclusion of this visit.

SUPERVISORS NAME: Efren Malagon
LICENSING EVALUATOR NAME: Beena Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2