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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191592733
Report Date: 05/22/2025
Date Signed: 05/22/2025 05:02:45 PM

Unsubstantiated


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
05/19/2025 and conducted by Evaluator Kimberly Ramirez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250519091549
FACILITY NAME:L.A HOMEFACILITY NUMBER:
191592733
ADMINISTRATOR:SALVADOR, ERLINDAFACILITY TYPE:
735
ADDRESS:13881 SARANACTELEPHONE:
(562) 941-2830
CITY:WHITTIERSTATE: CAZIP CODE:
90604
CAPACITY:6CENSUS: 4DATE:
05/22/2025
UNANNOUNCEDTIME BEGAN:
08:03 AM
MET WITH:Administrator Erlinda SalvadorTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Licensee did not ensure clients were adequately supervised.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced initial complaint investigation visit on 05/22/2025 to deliver findings regarding the above allegation. During today’s visit, LPA Ramirez was greeted by Direct Support Staff- Kaylonkyle Dela Rosa and explained the purpose of the visit. Administrator Erlinda Salvador arrived shortly after to assist with tour.

The investigation consisted of the following: LPA Ramirez requested and obtained copies of Clients#1-4 (C1-C40 Physician’s Report (LIC 602), copy of C2-C3 recent Individual Program Plan (IPP), Staff weekly schedule for May 12,2025 through May 17 2025, Staff# 2-4 (S2 – S4) Weekly Time Sheet for May 2025, Staff#1 - 4 interviews (S1 – S4), Client#1 interview (C1), Client#2-3 (C2-C3) were not present at the facility during visit and Client#4 (C4) has limited comprehension and therefore were not interviewed, and physical plant tour.

SEE 809-C for continued report.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Kimberly Ramirez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025
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 2
Control Number 28-AS-20250519091549
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: L.A HOME
FACILITY NUMBER: 191592733
VISIT DATE: 05/22/2025
NARRATIVE
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The investigation revealed the following: regarding the allegation “Licensee did not ensure clients were adequately supervised.” It is alleged on or around May 12, 2025, through May 14, 2025, between midnight and 3am, two unknown male clients were observed to be wandering outside near the facility. On 05/22/2025, LPA Ramirez reviewed C1-C4 physician’s report. C1-C4 physician’s report revealed, C1-C4 may leave the facility unassisted. LPA Ramirez reviewed staff weekly time sheets for May 2025. Staff weekly time sheets revealed on May 12, 2025, through May 14, 2025, one (1) staff was on duty between 10pm to 6am. Four (4) out of the four (4) staff interviewed did not corroborate this allegation. One (1) out of the one (1) client interviewed did not corroborate this allegation. LPA Ramirez made two attempts to interview nearby neighbors but was unable to make gain entry on to the property due to safety concerns and some neighbors refusing to speak with LPA Ramirez. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No deficiencies were cited during this visit. Exit interview was conducted. A copy of this report was provided via email.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Kimberly Ramirez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2