191220979-2-24-2026-31-AS-PMAA-DVATRC-20260622145719

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191220979
Report Date: 02/24/2026
Date Signed: 02/24/2026 02:44:54 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/18/2026 and conducted by Evaluator Huma Rahimi

COMPLAINT CONTROL NUMBER: 31-AS-20260218123820

FACILITY NAME:	MATEO'S HOME CARE		FACILITY NUMBER:	191220979
ADMINISTRATOR:	MATEO, ROGELIO D.		FACILITY TYPE:	735
ADDRESS:	18700 LEMAY STREET		TELEPHONE:	(818) 514-6807
CITY:	RESEDA	STATE: CA	ZIP CODE:	91335
CAPACITY:	4	CENSUS: 4	DATE:	02/24/2026
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Carolina Mateo, Administrator Designee		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Staff handled client in care in a rough manner.

INVESTIGATION FINDINGS:

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At 9:15 AM, Licensing Program Analyst (LPA) Huma Rahimi conducted an unannouced initial complaint visit to investigate the above stated allegation. LPA met with the Staff #1 (S1) Abraham Gazmen and Staff #2 (S2) Gaspara C Gazmen and the Administrator Designee was contacted via telephone. LPA explained the reason for the visit. The Designee arrived shortly after.

During course of the investigation, interviews and record review were made. At 9:20, LPA requested client and staff roster. At 9:25 AM, LPA requested copies of pertinent information which include, but not limited to Physician Report, Admission Agreement, Appraisal Needs and Services Plan, Staff Training and ect., relevant to the course of investigation. At approximately 9:30 AM, LPA conducted a physical plant tour. Between 9:35 AM to 1:15 PM, LPA conducted an interview with the Administrator Designee, Staff #1 (S1), Staff #2 (S2), North Los Angeles Regional Center (NLARC) Communicty Services Specialist, and two (2) out of four (4) clients who were able to communicate. Continue on LIC 9099C

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2026

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 31-AS-20260218123820

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: MATEO'S HOME CARE	FACILITY NUMBER: 191220979
	VISIT DATE: 02/24/2026

NARRATIVE

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Staff handled client in care in a rough manner.

It is alleged that the facility staff handled Client #1 (C1) in a rough manner. To investigate this allegation, LPA conducted interviews with Staff #1 (S1), Staff #2 (S2), two (2) out of four (4) clients who were able to communicate, the Administrator Designee, and the North Los Angeles Regional Center (NLARC) Community Services Specialist (CSS).

Interview with the Administrator Designee revealed being unaware of the incident until the initial visit conducted by the Regional Center. Interviews conducted with S1 and S2 denied the allegation. Both stated that S1 only held C1 from the back of the collar to provide support while assisting during dinner and did not grab or shake C1.

However, two (2) out of four (4) clients interviewed reported that after C1 spilled medication, S1 became upset and placed both hands around C1’s neck in an aggressive manner for several seconds.

LPA also conducted a telephonic interview with the (NLARC) (CSS), who reported that during site visits staff demonstrated holding C1 by the back of the collar and were observed using an improper support technique, which could result in handling in a rough manner.

Although no visible injuries were observed, consistent statements from two (2) clients indicate that C1 was handled in an aggressive and inappropriate manner. Therefore, based on interviews and investigative findings, this allegation is Substantiated.

Appeal rights explained and exit inter conducted.

Copy this report signed and delivered.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2026

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20260218123820

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: MATEO'S HOME CARE	FACILITY NUMBER: 191220979
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/24/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/03/2026 Section Cited CCR 80072(a)(1)	1 2 3 4 5 6 7	80072 Personal Rights (a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following: (1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Staff #1 will be removed from providing physical assistance until retraining is completed. All direct care staff will complete training on Personal Rights and proper physical assistance techniques. Proof of training will be submitted to Licensing by POC due date.
	8 9 10 11 12 13 14	Based on interviews, the licensee did not comply with the section cited above in at least one (01) out of four (04) clients which poses a potential Health, Safety, or Personal Rights risk to clients in care.	8 9 10 11 12 13 14	The Administrator will review physical handling and reporting policies with staff and maintain documentation for review.
	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.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2026

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2026

LIC9099 (FAS) - (06/04)

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