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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191592149
Report Date: 06/19/2025
Date Signed: 06/19/2025 04:19:32 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/16/2025 and conducted by Evaluator Christian Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250516131129
FACILITY NAME:LOVING CARE GUEST HOMEFACILITY NUMBER:
191592149
ADMINISTRATOR:SABIO, MARILYNFACILITY TYPE:
735
ADDRESS:15027 - 15031 BLACKWOOD STTELEPHONE:
(626) 917-2312
CITY:LA PUENTESTATE: CAZIP CODE:
91744
CAPACITY:12CENSUS: 10DATE:
06/19/2025
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Marilyn SabioTIME COMPLETED:
04:25 PM
ALLEGATION(S):
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Staff do not ensure adequate care and supervision is being provided to clients in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christian Gutierrez conducted a subsequent complain visit in regard to the allegations listed above. LPA met with Administrator Marilyn Sabio and explained the purpose of the visit.

The investigation consisted of the following: During the initial visit conducted on 05/20/2025, LPA interviewed Administrator, staff #1 and clients #2-4. LPA obtained copies of the following documents: client roster, C1’s identification, and emergency information LIC 601, preplacement appraisal, physicians report, house rules, and C1’s past history and physical examination. LPA Gutierrez also toured the facility. During today’s visit LPA Gutierrez delivered findings.

SEE 9099C
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Christian Gutierrez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025
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 5
Control Number 28-AS-20250516131129
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: LOVING CARE GUEST HOME
FACILITY NUMBER: 191592149
VISIT DATE: 06/19/2025
NARRATIVE
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In regard to the allegation “Staff do not ensure adequate care and supervision is being provided to clients in care”, it is alleged that staff are not preventing C1 from lighting a tree on fire. During interviews with Administrator and staff S1 both stated that they are aware of the situation and have spoken to family about this. S1 stated that they cannot watch C1 all the time they have to sleep too. Based on interviews with staff it was determined that staff is unable to communicate effectively with C1 due to language barrier. Administrator stated that it was only her husband and herself employed at the facility. During interviews with clients three (3) out of three (3) clients stated they have witnessed C1 setting tree on fire. LPA was able to view video footage of C1 on multiple occasions lighting the tree on fire.

Based on record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Deficiencies are being cited according to California Code of Regulations, Title 22 and Health and Safety Code.

An exit interview was conducted with Administrator Marilyn Sabio. A copy of the report and appeal rights were provided.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Christian Gutierrez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 28-AS-20250516131129
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: LOVING CARE GUEST HOME
FACILITY NUMBER: 191592149
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/03/2025
Section Cited
CCR
80065(b)(1)
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80065 Personnel Requirements
b) The licensing agency shall have the authority to require any licensee to provide additional staff whenever the licensing agency determines and documents that additional staff are required for the provision of services necessary to meet client needs. The licensee shall be informed in writing of the reasons for the licensing agency's determination. The following factors shall be taken into consideration in determining the need for additional staff.

(1) Needs of the particular clients.
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Administrator to submit a written plan by POC due date explaining how they will meet the requirement stated above.
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This deficiency is evidenced by the following:
Based on the needs of C1 the licensing agency has determined that additional staff is required to provide care and supervision of C1 due to multiple fires being set on property.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Christian Gutierrez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/16/2025 and conducted by Evaluator Christian Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250516131129

FACILITY NAME:LOVING CARE GUEST HOMEFACILITY NUMBER:
191592149
ADMINISTRATOR:SABIO, MARILYNFACILITY TYPE:
735
ADDRESS:15027 - 15031 BLACKWOOD STTELEPHONE:
(626) 917-2312
CITY:LA PUENTESTATE: CAZIP CODE:
91744
CAPACITY:12CENSUS: 10DATE:
06/19/2025
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Marilyn SabioTIME COMPLETED:
04:25 PM
ALLEGATION(S):
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Staff did not prevent client from having access to flammable objects
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christian Gutierrez conducted a subsequent complain visit in regard to the allegations listed above. LPA met with Administrator Marilyn Sabio and explained the purpose of the visit.

The investigation consisted of the following: During the initial visit conducted on 05/20/2025, LPA interviewed Administrator, staff #1 and clients #2-4. LPA obtained copies of the following documents: client roster, C1’s identification, and emergency information LIC 601, preplacement appraisal, physicians report, house rules, and C1’s past history and physical examination. LPA Gutierrez also toured the facility. During today’s visit LPA Gutierrez delivered findings.

SEE 9099C
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Christian Gutierrez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 28-AS-20250516131129
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: LOVING CARE GUEST HOME
FACILITY NUMBER: 191592149
VISIT DATE: 06/19/2025
NARRATIVE
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In regard to the allegation “Staff did not prevent client from having access to flammable objects”, It is alleged that C1 has access to flammable objects. During interviews with Administrator and staff both stated they can’t take lighter away because C1 smokes. Administrator stated they have asked family to assist in taking away lighters but C1 becomes more agitated. During record review it was revealed that per C1’s physicians report C1 is able to leave unassisted out of the facility. There is no evidence that C1 obtained lighters at facility, and it was possible he obtained them when out in the community.

Based on interviews conducted, and information that was gathered, there is insufficient evidence to support the allegation(s). Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

A copy of this report was given to the Administrator.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Christian Gutierrez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/19/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5