San Bernardino County Grand Jury • 2024-2025

Bernardino Cou

Published: December 13, 2024 95 pages Consolidated Report

Ver PDF original

⚠️ Aviso de traducción: Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.

⚠️ Este contenido ha sido traducido automáticamente. El texto original en inglés es la versión oficial. La traducción puede contener errores.

Findings 7 findings

The County’s R-1: The Grand Jury San made up of county the San Bernardino County ability to respond recommends that the Bernardino dept. leaders, County Emergency Board of quickly and County create and County hinders effective Operations Plan. June 30, 2025 Supervisors provide relief to maintain a plan for Board of emergency the citizens securing the use of the Supervisors June 30, 2025 planning, training, trapped by the type of equipment and heavy snowfall required to clear communications. was hampered by a accumulations of snow lack of proper greater than 8 feet from

Recommendation 2: June 30, City of The Grand Jury finds The Grand Jury recommends the 2025 Upland/City The survey utilized a 3-D imaging camera mounted on a vehicle which drives each the City of Upland City of Upland provide training in Council public street and alley in the city. The data collected is transferred into a software street repair crew is the hot mix process and provide program where a Pavement Condition Index (PCI) is determined. The PCI number not all trained in hot incentives to obtain their CDL. mix repair. along with associated unit cost factors for repairs, assists in providing a budgeting tool for future street maintenance. Finding 3: Recommendation 3: July 31, City of The Grand Jury finds The Grand Jury recommends the 2025 Upland/City the City of Upland City of Upland enhance their Council does not document current system with a procedure to follow-up contact document the date, time, photo 24 San Bernardino County Grand Jury Final Report • Hot mix is asphalt which is heated 350° and poured out of a shoot. The hot mix is a more permanent and costly repair. Hot mix is not maintained on site FINDINGS AND RECOMMENDATIONS and requires the use of a driver with a Commercial Driver’s License (CDL). Findings Recommendations When to Required • Grind and Overlay is a method that is used to dig out and remove asphalt and Implement Response replace with new asphalt. The grind and overlay method requires heavy Finding 1: Recommendation 1: June 30, City of The Grand Jury finds The Grand Jury recommends the 2025 Upland/City equipment and specific training and is contracted out by the City of Upland. the City of Upland City of Upland establish a Council The grind and overlay method are the most permanent and costly method of training for street documented training program, repair of potholes has which includes reference material the three mentioned. no clear timelines or on street deterioration, instructor- documentation for led training, and online training training. for pothole repair COMMENDATION:

Since the R-3: The Office of San saved lives and prevented more property loss. However, poor communication with agencies were not Emergency Services Bernardino trained to should develop a plan County the public, insufficient management training, and the County’s first ever blizzard left understand the and accompanying Board of county residents with the impression that more could have been done. County Emergency training for all county Supervisors Operations plan, departments, including June 30, 2025 they were poorly the Board of coordinated Supervisors, to causing the function according to community to the San Bernardino FINDINGS AND RECOMMENDATIONS: suffer delays in County Emergency needed services. Operations Plan. Implementation Required Findings Recommendations Date Response F-4: The Lack of a R-4: Establish a San Disaster Council Disaster Council per Bernardino

Recommendation 4: July 31, City of CDL: Commercial Driver’s License The Grand Jury finds The Grand Jury recommends the 2025 Upland/City the City of Upland City of Upland provide Council Cold Mix: Product that is used in dry weather to repair potholes does not notify the notification to the party who citizen who reported submitted the repair request. The Greenbook: Standard Specifications for Public Works Construction the pothole when a notification should be done in reported pothole either a hard copy or electronic repair is completed format for efficiency. We Grind and Overlay: Milling off the top layer of existing asphalt (known as recommend the notification be the “mill”). Replacing it with a new layer of asphalt (known as the “overlay”). automatically generated. This process helps rehabilitate and extend the life of the pavement.

Recommendation 5: April 30, City of The Grand Jury finds The Grand Jury recommends the 2025 Upland/City Hot Mix: Product that is used in wet weather to repair potholes the lack of quality City of Upland establish a quality Council control impacts the control protocol for pothole training and the repairs. The protocol should Lute: Flattening the hole accuracy of repairs. include a checklist which includes an assigned team member responsible for quality control, NOBEL: Operations management software that presents suite of innovative photos before and after the repair utility management solutions that empower organization to achieve their and the method of repair. The operational goals. checklist should become a part of the repair documentation in their reporting system. PCI: Pavement condition index. Numerical rating of the pavement conditions based on the type and severity of distresses observed on the pavement surface. PQI: Pavement Quality Index Slurry and Seal: A type of pavement maintenance treatment that uses emulsified asphalt, water, fine aggregate and mineral filler. San Bernardino County Grand Jury Final Report GLOSSARY: when a pothole is not and form of contact made to verify located. the location. AASHTO: American Association of State Highway and Transportation Officials

After the R-6a: OES and the June 30, 2025 San CEO – Chief Executive Officer: leads the County Administration Office and the County’s County’s CEO Bernardino Emergency negotiate County Executive Team, who work with the Board of Supervisors and other stakeholders to Proclamation, the Memorandums of Board of serve the county residents and investors. formation of the Understanding (MoUs) Supervisors EOC, and the for resources likely to DPW – Department of Public Works: Provides services in the following areas: state’s Emergency be included in future Transportation, Flood Control, Solid Waste, Surveyor, Special Districts, permits, Declaration, OES emergencies. and some agencies inspections, planning, maps, roads, paving, traffic, snow removal, water and were hesitant to sanitation, zoo, parks, landfills, organic waste recycling, environmental planning and fully function in R-6b: Department June 30, 2025 San unified Heads of County Bernardino maintenance, stormwater, contracts, project proposals, and public notices. command. agencies be formally County trained on their Board of EOC – Emergency Operations Center: is a central command and control responsibilities during Supervisors "coordination structure" responsible for managing emergency response, emergency an emergency, both preparedness, emergency management, and disaster management functions at a before and after a county Emergency strategic level during an emergency. Proclamation. IMT – Incident Management Team: An incident management team is a group of

The EOC did R-7: Department heads June 30, 2025 San trained personnel that responds to emergencies and complex incidents. They provide not have a be trained in EOC Bernardino functioning unified responsibilities and County command and control infrastructure to manage various aspects of incidents, command, held accountable for Board of including operational, logistical, informational, planning, fiscal, community, resulting in County their agency’s Supervisors 48 San Bernardino County Grand Jury Final Report Operations Plan include a plan to deal June 30, 2025 County resources not participation in the has not been with a unique winter Board of being used EOC. updated since 2019 snowstorm and other Supervisors effectively. and the plan does unusual events. not cover a snow event like the county had in R-5b: Require all September 30, San GLOSSARY: 2023. County departments 2025 Bernardino perform and record an County BOS – Board of Supervisors (San Bernardino County): The Board of Supervisors is annual review of the Board of like a city council in that its members are elected by residents to represent their County Emergency Supervisors Operations Plan. interests and make policy decisions on government services, policies and finances.

Recommendations 19

R1a

The Grand Jury recommends the The Grand Jury commends the City of Upland, Public Works Department City of Upland maintain a (Department) for being proactive in its endeavors in identifying street deterioration. checklist of the steps completed in training, proficiency made in This is evidenced by the Department contracting with Transmap a surveying training and maintain the checklist company on June 26, 2023. Transmap conducted a pavement management survey. in their individual and or personnel file. The survey analyzed and assessed the conditions of the public streets in the city of Upland.
R2

Assistant Executive Officer for Finance and Administration assigned to assist the Disaster Council in their absence;
R3

Assistant Executive Officer for Human Services The County Counsel or a Deputy County Counsel assigned to advise the County’s
R4

Fire Chief/Fire Warden Office of Emergency Services in their absence;
R5

Auditor-Controller/Treasurer/Tax Collector Such other persons as are required by the Disaster Council. Per County Code Section 21.0108, the San Bernardino County Disaster Council is hereby empowered 6. Assessor-Recorder-County Clerk to:
R7

County Sheriff/Coroner/Public Administrator Advise and recommend for adoption by the Board of Supervisors, emergency plans,
R8

Deputy Executive Officer for Community Services mutual aid agreements, and such ordinances, resolutions, rules and regulations as
R9

Director of the Human Resources Department are necessary to implement such plans and agreements, and to serve as the San Bernardino County Citizen Corps Council. 10. Director of the Risk Management Department The Disaster Council shall meet at least annually or upon call of the Disaster 11. Public Health Director Council Chairperson, or the Manager of the Office of Emergency Services, as often
R12

County Health Officer as is deemed necessary by such persons.
R13

Director of Behavioral Health The Disaster Council will attain and maintain accreditation.
R14

Director of Arrowhead Regional Medical Center The Disaster Council is certified by the California Emergency Council as
R15

Director of Information Services Department conforming with the rules and regulations established by the California Emergency 38 San Bernardino County Grand Jury Final Report Per County Code Section 21.0107: Council pursuant to the provisions of Article 10 of Chapter 7 of Division 1 of Title 2 of the California Government Code. The Chief Executive Officer shall serve as the Disaster Council Chairperson. A Disaster Council remains accredited only while the certification of the Cal In the absence of the CEO, the Fire Chief/Fire Warden of the San Bernardino County California Emergency Council is in effect and is not revoked. Fire Protection District shall serve as the Disaster Council Chairperson. The staff assigned to assist the Disaster Council carry out its powers and duties shall consist Per County Code Section 21.0106, the San Bernardino County Disaster Council of the following: shall consist of the following 20 voting members and one nonvoting member: The Manager of the Office of Emergency Services shall serve as the Executive 1. Chief Executive Officer Director of the Disaster Council to facilitate its operations, or an OES staff member
R16

Director of Purchasing The initial storm dumped approximately seven feet of snow on the San Bernardino County mountain communities in the first several days beginning on February 23rd.
R17

Director of the Special Districts Department Subsequent storms added another four feet of fresh snow bringing the total to 11
R18

Director of the Department of Public Works feet.
R19

Director of Land Use Services Once this accumulation reached five feet, it was reported that the County snowplows
R20

County Superintendent of Schools were ineffective in handling the volume of snow.
R21

A non-voting at-large Representative of the designated lead agency of the San The County had to bring in additional equipment to assist with snow removal, which Bernardino County Operational Area Coordinating Council (OACC) slowed down the process of reopening the roads. Note: The twenty (20) voting members may select a pre-designated representative to The public was not well informed during this disaster and was unable to get reliable serve in his or her absence. disaster and relief information during the event. The Emergency Operations Center did not pre-position the needed supplies in The County established a remote call center modeled after the call center utilized locations to be hit by the storm. during the COVID response. This was ineffective in providing information and gathering data from the public in real time. This further exacerbated the public’s The County did not have a pre-disaster donations management and warehouse frustration with the County’s response to the storm. staffing plan, which led to a delayed and ineffective distribution of needed emergency food and medical supplies. The County lacks a crisis communications plan and that, coupled with the delayed activation of the Public Information team, created an opportunity for misinformation The Grand Jury learned that the County was unable to deal with a sudden influx of and rumors. This led to the public perception that the County wasn’t dealing donated emergency relief supplies because of staffing, warehousing, and logistics effectively with the disaster. issues. Volunteers need to be trained before an emergency to ensure the safety of the The lack of a concerted and coordinated effort was exacerbated by a lack of residents served, the volunteers’ safety, respect for private property and the knowledge of the existence of the County emergency plans or an understanding of environment. how to implement these plans by County departmental staff and elected officials. People saw the social media accounts of San Bernardino County’s storm of 2023 and Because of these deficiencies, distribution of emergency supplies was hampered. were concerned and wanted to help. But, because offers to help came from social Snow-clearing operations were impeded by a lack of equipment capable of removing snow in the amounts the storm delivered. San Bernardino County Grand Jury Final Report
R11-19

hours 9 found the form in only eight of the 51 jackets. Usually, when there was a document 20 or more hours 4 Total Number of 41 showing the date an arrestee was released, it did not explicitly state the time of People Assessed release. The document titled San Bernardino County Sheriff’s Department Booking Table 2 created by the San Bernardino County Civil Grand Jury Record has an area at the bottom left of the page for Release Information. Many times, this document has the release date written in but not the release time. Often Four spent more than 20 hours in custody. Some of these four arrestees Time in other databases had to be consulted to obtain information about when an arrestee Custody were due to medical issues. Nine spent 11 -19 hours in custody. Eight spent was released from custody. Sometimes the Release Time information was not 7-10 hours in custody. Eleven spent 5-6 hours in custody. Nine spent 1-4 hours in custody. The exact amount of time in custody for 11 of the arrestees is unknown 72 San Bernardino County Grand Jury Final Report the booking error arrest happened and what might be done to prevent it from located in any administrative records. Yet almost all the jackets had paperwork that occurring in the future. clearly stated the time of the arrest. POST-BOOKING PROCEDURE 1 More than half those who were arrested and jailed were released with no documentation in their booking jackets about how long they were detained. The Evidence revealed the Department’s Error Arrests database is not organized to evidence showed time in custody for only 41 of the 51 mistaken identity arrestees. immediately generate the “jackets” of booking error warrant arrests. The mistaken Twenty-one of the 41 people who the Grand Jury has Time of Release information identity warrant arrest administrative file is not available in a timely and efficient spent seven or more hours in custody before they were released. Twenty people spent manner. six or fewer hours in custody. The breakdown is shown in Table 2. Moreover, when mistaken identity warrant booking error jackets were reviewed, TABLE 2: Number of Hours in Custody During Booking Error Warrant they often had incomplete sets of forms. For example, there were no booking error Arrests jackets available for eight of the 51 mistaken identity warrant arrests. In those cases where a booking error jacket was available, a copy of receipts showing Date and Hours in Custody Number of People Released in Time of Release was missing from all but eight of the booking jackets. The Each Time Frame Category paperwork in the arrested people’s booking jackets often did not include a “San 1-4 hours 9 5-6 hours 11 Bernardino County Sheriff’s Department Release Receipt.” It is a computer- 7-10 hours 8 generated document when the subject is released from custody. The Grand Jury

Commendations 21

CM1 Page 61

Since the R-3: The Office of San saved lives and prevented more property loss. However, poor communication with agencies were not Emergency Services Bernardino trained to should develop a plan County the public, insufficient management training, and the County’s first ever blizzard left understand the and accompanying Board of county residents with the impression that more could have been done. County Emergency training for all county Supervisors Operations plan, departments, including June 30, 2025 they were poorly the Board of coordinated Supervisors, to causing the function according to community to the San Bernardino FINDINGS AND RECOMMENDATIONS: suffer delays in County Emergency needed services. Operations Plan. Implementation Required Findings Recommendations Date Response F-4: The Lack of a R-4: Establish a San Disaster Council Disaster Council per Bernardino
CM2 Page 41

Recommendation 4: July 31, City of CDL: Commercial Driver’s License The Grand Jury finds The Grand Jury recommends the 2025 Upland/City the City of Upland City of Upland provide Council Cold Mix: Product that is used in dry weather to repair potholes does not notify the notification to the party who citizen who reported submitted the repair request. The Greenbook: Standard Specifications for Public Works Construction the pothole when a notification should be done in reported pothole either a hard copy or electronic repair is completed format for efficiency. We Grind and Overlay: Milling off the top layer of existing asphalt (known as recommend the notification be the “mill”). Replacing it with a new layer of asphalt (known as the “overlay”). automatically generated. This process helps rehabilitate and extend the life of the pavement.
CM3 Page 63

After the R-6a: OES and the June 30, 2025 San CEO – Chief Executive Officer: leads the County Administration Office and the County’s County’s CEO Bernardino Emergency negotiate County Executive Team, who work with the Board of Supervisors and other stakeholders to Proclamation, the Memorandums of Board of serve the county residents and investors. formation of the Understanding (MoUs) Supervisors EOC, and the for resources likely to DPW – Department of Public Works: Provides services in the following areas: state’s Emergency be included in future Transportation, Flood Control, Solid Waste, Surveyor, Special Districts, permits, Declaration, OES emergencies. and some agencies inspections, planning, maps, roads, paving, traffic, snow removal, water and were hesitant to sanitation, zoo, parks, landfills, organic waste recycling, environmental planning and fully function in R-6b: Department June 30, 2025 San unified Heads of County Bernardino maintenance, stormwater, contracts, project proposals, and public notices. command. agencies be formally County trained on their Board of EOC – Emergency Operations Center: is a central command and control responsibilities during Supervisors "coordination structure" responsible for managing emergency response, emergency an emergency, both preparedness, emergency management, and disaster management functions at a before and after a county Emergency strategic level during an emergency. Proclamation. IMT – Incident Management Team: An incident management team is a group of
CM4 Page 61

The County’s R-1: The Grand Jury San made up of county the San Bernardino County ability to respond recommends that the Bernardino dept. leaders, County Emergency Board of quickly and County create and County hinders effective Operations Plan. June 30, 2025 Supervisors provide relief to maintain a plan for Board of emergency the citizens securing the use of the Supervisors June 30, 2025 planning, training, trapped by the type of equipment and heavy snowfall required to clear communications. was hampered by a accumulations of snow lack of proper greater than 8 feet from
CM5 Page 53

Assistant Executive Officer for Finance and Administration assigned to assist the Disaster Council in their absence;
CM6 Page 53

Assistant Executive Officer for Human Services The County Counsel or a Deputy County Counsel assigned to advise the County’s
CM7 Page 53

Fire Chief/Fire Warden Office of Emergency Services in their absence;
CM8 Page 53

Auditor-Controller/Treasurer/Tax Collector Such other persons as are required by the Disaster Council. Per County Code Section 21.0108, the San Bernardino County Disaster Council is hereby empowered 6. Assessor-Recorder-County Clerk to:
CM9 Page 53

County Sheriff/Coroner/Public Administrator Advise and recommend for adoption by the Board of Supervisors, emergency plans,
CM10 Page 53

Deputy Executive Officer for Community Services mutual aid agreements, and such ordinances, resolutions, rules and regulations as
CM11 Page 53

Director of the Human Resources Department are necessary to implement such plans and agreements, and to serve as the San Bernardino County Citizen Corps Council. 10. Director of the Risk Management Department The Disaster Council shall meet at least annually or upon call of the Disaster 11. Public Health Director Council Chairperson, or the Manager of the Office of Emergency Services, as often
CM12 Page 53

County Health Officer as is deemed necessary by such persons.
CM13 Page 53

Director of Behavioral Health The Disaster Council will attain and maintain accreditation.
CM14 Page 53

Director of Arrowhead Regional Medical Center The Disaster Council is certified by the California Emergency Council as
CM15 Page 53

Director of Information Services Department conforming with the rules and regulations established by the California Emergency 38 San Bernardino County Grand Jury Final Report Per County Code Section 21.0107: Council pursuant to the provisions of Article 10 of Chapter 7 of Division 1 of Title 2 of the California Government Code. The Chief Executive Officer shall serve as the Disaster Council Chairperson. A Disaster Council remains accredited only while the certification of the Cal In the absence of the CEO, the Fire Chief/Fire Warden of the San Bernardino County California Emergency Council is in effect and is not revoked. Fire Protection District shall serve as the Disaster Council Chairperson. The staff assigned to assist the Disaster Council carry out its powers and duties shall consist Per County Code Section 21.0106, the San Bernardino County Disaster Council of the following: shall consist of the following 20 voting members and one nonvoting member: The Manager of the Office of Emergency Services shall serve as the Executive 1. Chief Executive Officer Director of the Disaster Council to facilitate its operations, or an OES staff member
CM16 Page 55

Director of Purchasing The initial storm dumped approximately seven feet of snow on the San Bernardino County mountain communities in the first several days beginning on February 23rd.
CM17 Page 55

Director of the Special Districts Department Subsequent storms added another four feet of fresh snow bringing the total to 11
CM18 Page 55

Director of the Department of Public Works feet.
CM19 Page 55

Director of Land Use Services Once this accumulation reached five feet, it was reported that the County snowplows
CM20 Page 55

County Superintendent of Schools were ineffective in handling the volume of snow.
CM21 Page 55

A non-voting at-large Representative of the designated lead agency of the San The County had to bring in additional equipment to assist with snow removal, which Bernardino County Operational Area Coordinating Council (OACC) slowed down the process of reopening the roads. Note: The twenty (20) voting members may select a pre-designated representative to The public was not well informed during this disaster and was unable to get reliable serve in his or her absence. disaster and relief information during the event. The Emergency Operations Center did not pre-position the needed supplies in The County established a remote call center modeled after the call center utilized locations to be hit by the storm. during the COVID response. This was ineffective in providing information and gathering data from the public in real time. This further exacerbated the public’s The County did not have a pre-disaster donations management and warehouse frustration with the County’s response to the storm. staffing plan, which led to a delayed and ineffective distribution of needed emergency food and medical supplies. The County lacks a crisis communications plan and that, coupled with the delayed activation of the Public Information team, created an opportunity for misinformation The Grand Jury learned that the County was unable to deal with a sudden influx of and rumors. This led to the public perception that the County wasn’t dealing donated emergency relief supplies because of staffing, warehousing, and logistics effectively with the disaster. issues. Volunteers need to be trained before an emergency to ensure the safety of the The lack of a concerted and coordinated effort was exacerbated by a lack of residents served, the volunteers’ safety, respect for private property and the knowledge of the existence of the County emergency plans or an understanding of environment. how to implement these plans by County departmental staff and elected officials. People saw the social media accounts of San Bernardino County’s storm of 2023 and Because of these deficiencies, distribution of emergency supplies was hampered. were concerned and wanted to help. But, because offers to help came from social Snow-clearing operations were impeded by a lack of equipment capable of removing snow in the amounts the storm delivered. 40 San Bernardino County Grand Jury Final Report

No Responses Found 2

Government entities assigned to respond to this report. No response documents have been linked in our database.

County of San Bernardino Agency

San Bernardino County Board of Supervisors Elected County Office