191221933-5-18-2026-31-AS-NGID-DVLVX9-20260702164910

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191221933
Report Date: 05/18/2026
Date Signed: 05/18/2026 02:59:58 PM

Unsubstantiated

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
05/08/2026 and conducted by Evaluator Huma Rahimi

COMPLAINT CONTROL NUMBER: 31-AS-20260508144147

FACILITY NAME:	MATEO'S GUEST HOME		FACILITY NUMBER:	191221933
ADMINISTRATOR:	MATEO, CAROLINA & ROGELIO		FACILITY TYPE:	735
ADDRESS:	6861 TAMPA AVE.		TELEPHONE:	(818) 776-8716
CITY:	RESEDA	STATE: CA	ZIP CODE:	91335
CAPACITY:	4	CENSUS: 4	DATE:	05/18/2026
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Carolina Mateo, Administrator		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Facility failed to address rodent problem (mice/rats,etc).
Staff neglected to provide proper supervision to client.

INVESTIGATION FINDINGS:

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At 9:15 AM, Licensing Program Analyst (LPA) Huma Rahimi a long with the North Los Angeles County Regional Center (NLACRC) Consumer Services Coordinator, Noemi Herrera, conducted an unannounced initial complaint visit to investigate the above stated allegations. LPA met with the Administrator and explained the reason for the visit.

During course of the investigation, interviews and record review were made. At 9:20 AM, 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, Pest Control Company contract/invoice and ect., relevant to the course of investigation. At 9:30 AM, LPA conducted a physical plant tour. Between 9:35 AM - 2:15 PM, LPA conducted an interview with the Administrator, Staff #1 (S1), and three (3) out of four (4) clients who were able to communicate.
Continue on LIC 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20260508144147

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 GUEST HOME	FACILITY NUMBER: 191221933
	VISIT DATE: 05/18/2026

NARRATIVE

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Allegation: Facility failed to address rodent problem (mice/rats, etc.)

It was alleged that the facility failed to address a rodent problem within the home. To investigate this allegation, LPA interviewed the Administrator, Staff #1 (S1), and three (3) clients, and reviewed facility records, including the incident report submitted to Community Care Licensing Division (CCLD) on 05/11/2026 and pest control company invoices. The Administrator and S1 denied the allegation and stated the facility did not have an active rodent infestation. The Administrator stated pest control services were requested on 05/11/2026 and completed on 05/12/2026 with no evidence of rodents found. LPA reviewed pest control documentation, which confirmed the Administrator’s statement. Review of the incident report revealed staff attempted to obtain additional information from Client #1 (C1) regarding the reported mouse incident; however, C1 was unable to provide specific details regarding the event. Interview with C1 revealed C1 independently purchased a mouse trap after reportedly seeing a mouse; however, C1 provided inconsistent statements regarding placement of the trap and how the mouse was caught. During the inspection, LPA did not observe droppings, holes, foul odors, infestation, or unsanitary conditions throughout the facility. Interviews with two (2) out of three (3) clients revealed no observations of rodents or droppings, and both stated the facility is kept clean and sanitary.

Based on interviews, records reviewed, and LPA observations, there was insufficient evidence to support the allegation that the facility failed to address a rodent problem. Therefore, this allegation is Unsubstantiated at this time.

Allegation: Staff neglected to provide proper supervision to client

It was alleged that staff neglected to provide proper supervision to Client #1 (C1) after C1 was reportedly found carrying a dead mouse/rat in the community. To investigate this allegation, LPA interviewed the Administrator and three (3) clients and reviewed C1’s facility records. The Administrator and S1 denied the allegation and stated staff were unaware C1 had been carrying the dead animal and would have addressed the matter immediately if staff had known. The Administrator further stated C1 is considered high functioning, prefers minimal interaction with staff and clients, and often chooses to remain alone in their room. On 05/04/2026, during a meeting with NLACRC staff, C1 disclosed being in possession of a dead mouse/rat, at which time staff immediately assisted with disposal of the animal. C1 confirmed staff assisted with disposal after being informed. Continue on LIC 9099C

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2026

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20260508144147

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 GUEST HOME	FACILITY NUMBER: 191221933
	VISIT DATE: 05/18/2026

NARRATIVE

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Review of C1’s IPP revealed C1 is able to meet self-care needs independently, prepare meals independently, and communicate effectively, including expressing needs, preferences, and concerns, and advocating for services when needed. Interviews with two (2) out of three (3) clients revealed no concerns regarding staff supervision and both stated staff consistently provide care, supervision, and assistance to clients in care. During the investigation, LPA observed staff interacting appropriately with clients and no immediate supervision concerns were noted.

Based on interviews, records reviewed, and LPA observations, there was insufficient evidence to support the allegation that staff neglected to provide proper supervision to C1. Therefore, this allegation is Unsubstantiated at this time.

Exit interview conducted and appeal rights explained.

Copy of this report signed and delivered.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Huma Rahimi
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2026

LIC9099 (FAS) - (06/04)

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