191601613-4-3-2026-11-AS-SCIS-DU8VSW-20260519164214

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191601613
Report Date: 04/03/2026
Date Signed: 04/03/2026 02:39:22 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/26/2026 and conducted by Evaluator Lizeth Villegas

COMPLAINT CONTROL NUMBER: 11-AS-20260326145144

FACILITY NAME:	WILMINGTON GARDENS		FACILITY NUMBER:	191601613
ADMINISTRATOR:	FLORES,V.ANDT.		FACILITY TYPE:	735
ADDRESS:	1311 WEST ANAHEIM STREET		TELEPHONE:	(310) 835-6366
CITY:	WILMINGTON	STATE: CA	ZIP CODE:	90744
CAPACITY:	48; 48	CENSUS: 38	DATE:	04/03/2026
		UNANNOUNCED	TIME BEGAN:	09:41 AM
MET WITH:	Vic J. Flores		TIME COMPLETED:	02:46 PM

ALLEGATION(S):

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Licensee does not ensure pest issue is handled correctly.
Staff does not ensure windows in clients rooms have coverings.
Staf does not ensure clients rooms are provided with dressers for clothing.
Staff does not ensure bathrooms are kept clean and sanitary for clients.
Staff does not ensure clients are spoken to in an appropriate manner.

INVESTIGATION FINDINGS:

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On 04/03/26 at 9:30 am Licensing Program Analyst (LPA) Villegas conducted an initial complaint visit regarding the allegation(s) above. LPA met with Fay Pacificador as the purpose of today’s visit was explained. Vic J. Flores staff #1 (S1) later arrived at the facility to assist LPA.

The investigation consisted of the following: On 04/03/26 LPA Villegas obtained copies of the staff and client rosters, staff shift schedule and duties, Orkin service report dated: 03/31/26, Orkin K9 bed bug division report dated 03/20/26, and Orkin service plan and estimate dated 03/24/26. On 04/03/26 from 10:00 am- 11:00 am LPA conducted Interviews with clients # 1-5 (C1-C5). On 04/03/26 from 11:00 am-11:12 pm

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026

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 7

Control Number 11-AS-20260326145144

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: WILMINGTON GARDENS	FACILITY NUMBER: 191601613
	VISIT DATE: 04/03/2026

NARRATIVE

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LPA and S1 conducted tour of the facility and all bedrooms and bathrooms. On 04/03/26 from 1:15 pm - 1:45 pm LPA conducted interviews with staff #1-2 (S1-S2).

The investigation revealed the following:
Allegation: Licensee does not ensure pest issue is handled correctly.
It is being alleged that the facility has bedbugs and roaches. On 04/03/26 from 10:00 am- 11:00 am LPA conducted Interviews with C1-C5 regarding the allegation above. 3 of the 5 clients interviewed denied the allegation above, 2 of the 5 clients interviewed confirmed the allegation above and reported seeing both roaches and bedbug at the facility. 5 of the 5 clients interviewed reported that pest control is coming out to service the facility. On 04/03/26 from 11:00 am-11:12 pm LPA and S1 conducted tour of the facility and all bedrooms and bathrooms, during tour of the facility LPA did not observe any activity or roaches nor bedbugs at the facility. On 04/03/26 from 1:15 pm - 1:45 pm LPA conducted interviews with S1-S2 regarding the allegation above, 2 of the 2 staff interviewed denied the allegation above and reported that the facility has been actively deep cleaned and the facility is being services by Pest control. Additionally, S1 reported that the facility has a plan with Orkin to treat both buildings at once, plan is indicated in the Orkin service plan and estimate dated 03/24/26. On 04/03/26 LPA conducted a review of Orkin service report dated: 03/31/26, Orkin K9 bed bug division report dated 03/20/26, and Orkin service plan and estimate dated 03/24/26.Per documents reviewed, the facility is actively being serviced, per Orkin service report dated: 03/31/26, technician found and removed (3) dead roaches and did not observe any live roaches or bed bugs.

Allegation: Staff does not ensure windows in clients rooms have coverings.
It is being alleged that the facility does not have proper window coverings for the clients windows. On 04/03/26 from 10:00 am- 11:00 am LPA conducted Interviews with C1-C5 regarding the allegation above. 5 of the 5 clients interviewed denied the allegation above. On 04/03/26 from 11:00 am-11:12 pm LPA and S1 conducted tour of the facility and all bedrooms and bathrooms, during tour of the facility LPA observed all windows to have window screens. On 04/03/26 from 1:15 pm - 1:45 pm LPA conducted interviews with S1-S2 regarding the allegation above, 2 of the 2 staff interviewed denied the allegation above.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026

LIC9099 (FAS) - (06/04)

Page: 6 of 7

Control Number 11-AS-20260326145144

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: WILMINGTON GARDENS	FACILITY NUMBER: 191601613
	VISIT DATE: 04/03/2026

NARRATIVE

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Allegation: Staff does not ensure clients rooms are provided with dressers for clothing.
It is being alleged that the majority of the clients don't have dressers in their bedrooms.
On 04/03/26 from 10:00 am- 11:00 am LPA conducted Interviews with C1-C5 regarding the allegation above. 4 of the 5 clients interviewed denied the allegation above, 1 of the 5 clients interviewed confirmed the allegation above and reported having clothes in a bag. On 04/03/26 from 11:00 am-11:12 pm LPA and S1 conducted tour of the facility and all bedrooms and bathrooms, during tour of the facility LPA observed all bedrooms have shared closet space and a dresser space to store personal belongings. Additionally LPA observed extra dressers in the storage room. On 04/03/26 from 1:15 pm - 1:45 pm LPA conducted interviews with S1-S2 regarding the allegation above, 2 of the 2 staff interviewed denied the allegation above, and reported that new dressers have been purchased to replace any damaged/broken dressers.

Allegation: Staff does not ensure bathrooms are kept clean and sanitary for clients.
It is being alleged that facility toilet seats are broken and that 2 of the toilets in the old building don't flush properly. On 04/03/26 from 10:00 am- 11:00 am LPA conducted Interviews with C1-C5 regarding the allegation above. 5 of the 5 clients interviewed denied the allegation above and reported that the bathrooms are cleaned daily and are not in disrepair. On 04/03/26 from 11:00 am-11:12 pm LPA and S1 conducted tour of the facility and observed the toilets to have a toilet seat and are operational. LPA also observed staff cleaning the facility during the visit. On 04/03/26 from 1:15 pm - 1:45 pm LPA conducted interviews with S1-S2 regarding the allegation above, 2 of the 2 staff interviewed denied the allegation above and reported that bathrooms are cleaned daily. Additionally, 2 of 2 staff reported that if a clients reports a problem with the bathroom staff will be fixed the same day or the following day depending on the type of repair needed.

Allegation: Staff does not ensure clients are spoken to in an appropriate manner.
it is being alleged that facility staff go around screaming at the clients. On 04/03/26 from 10:00 am- 11:00 am LPA conducted Interviews with C1-C5 regarding the allegation above. 4 of the 5 clients interviewed denied the allegation above, 1 of the 5 clients interviewed confirmed the allegation above and reported that staff sometimes yells at the

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026

LIC9099 (FAS) - (06/04)

Page: 7 of 7

Control Number 11-AS-20260326145144

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: WILMINGTON GARDENS	FACILITY NUMBER: 191601613
	VISIT DATE: 04/03/2026

NARRATIVE

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client when client ask what is for dinner. On 04/03/26 from 1:15 pm - 1:45 pm LPA conducted interviews with S1-S2 regarding the allegation above, 2 of the 2 staff interviewed denied the allegation above and reported having a good rapport with clients in care.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Exit interview conducted, and a copy of this report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 7

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/26/2026 and conducted by Evaluator Lizeth Villegas

COMPLAINT CONTROL NUMBER: 11-AS-20260326145144

FACILITY NAME:	WILMINGTON GARDENS		FACILITY NUMBER:	191601613
ADMINISTRATOR:	FLORES,V.ANDT.		FACILITY TYPE:	735
ADDRESS:	1311 WEST ANAHEIM STREET		TELEPHONE:	(310) 835-6366
CITY:	WILMINGTON	STATE: CA	ZIP CODE:	90744
CAPACITY:	48; 48	CENSUS: 38	DATE:	04/03/2026
		UNANNOUNCED	TIME BEGAN:	09:41 AM
MET WITH:	Vic J. Flores		TIME COMPLETED:	02:46 PM

ALLEGATION(S):

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9

Staff does not ensure faility is kept in good repair.

INVESTIGATION FINDINGS:

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Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026

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

LIC9099 (FAS) - (06/04)

Page: 3 of 7

Control Number 11-AS-20260326145144

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: WILMINGTON GARDENS	FACILITY NUMBER: 191601613
	VISIT DATE: 04/03/2026

NARRATIVE

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LPA and S1 conducted tour of the facility and all bedrooms and bathrooms. On 04/03/26 from 1:15 pm - 1:45 pm LPA conducted interviews with staff #1-2 (S1-S2).

Allegation: Staff does not ensure facility is kept in good repair.
It is being alleged that the facility currently has 4 broken windows. On 04/03/26 from 10:00 am- 11:00 am LPA conducted Interviews with C1-C5 regarding the allegation above. 5 of the 5 clients interviewed denied the allegation above. On 04/03/26 from 1:15 pm - 1:45 pm LPA conducted interviews with S1-S2. 2 of the 2 staff interviewed denied the allegation above and reported that they are unaware of any broken windows at the facility. On 04/03/26 from 11:00 am-11:12 pm LPA and S1 conducted tour of the facility and that the window in bedrooms #1 and 12 are broken.

on LPAs observations and interviews which were conducted record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be substantiated. California Code of Regulations, Title 22, Division (6) and Chapter (6) are being cited on the attached LIC 9099D.

Exit interview conducted, appeal rights explained, and a copy of this report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026

LIC9099 (FAS) - (06/04)

Page: 4 of 7

Control Number 11-AS-20260326145144

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: WILMINGTON GARDENS	FACILITY NUMBER: 191601613
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/03/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/01/2026 Section Cited HSC 80087(a)	1 2 3 4 5 6 7	80087 Buildings and Grounds (a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.	1 2 3 4 5 6 7	Licensee/Administrator to order new window glass to replace broken windows in bedrooms #1 and 12. LPA to receive copy of receipt(s) and picures or repaired windows as proof by POC due date.
	8 9 10 11 12 13 14	This requirement was not met as LPA observed the windows in bedrooms #1 and 12 to be broken which poses a potential health and safety risk to clients in care.	8 9 10 11 12 13 14
	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: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2026

LIC9099 (FAS) - (06/04)

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