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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197602744
Report Date: 10/23/2025
Date Signed: 11/10/2025 08:57:34 AM

Unfounded


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
07/29/2025 and conducted by Evaluator Mary G Flores
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250729094110
FACILITY NAME:TERRACES AT PARK MARINO, THEFACILITY NUMBER:
197602744
ADMINISTRATOR:MARIA TERESITA QUIZONFACILITY TYPE:
740
ADDRESS:2587 E. WASHINGTON BLVD.TELEPHONE:
(626) 798-6753
CITY:PASADENASTATE: CAZIP CODE:
91107
CAPACITY:112CENSUS: 0DATE:
10/23/2025
UNANNOUNCEDTIME BEGAN:
03:35 PM
MET WITH:Maria Quizon - Administrator TIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Resident received unexplained injury due to neglect
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mary Flores conducted an unannounced complaint visit regarding the above allegation. Due to the Eaton fire, facility was destroyed and therefore this visit is being completed via telephone. LPA contacted administrator, Maria Quizon over the phone and explained the reason for the investigation.

The investigation consisted of the following: On 8/6/25 LPA Flores conducted an initial investigation via telephone, interviewed administrator, and requested a resident/staff roster. On 8/20/25 LPA Flores attempted to contact administrator for skill nursing facility adjacent to facility. On 8/27/25 LPA Flores attempted to request a copy of Los Angeles Sheriff’s department (LASD) report. On 10/22/25 Investigator Bureau Amina Luckett from the Investigation Department Bureau provided LPA Flores a copy of LASD report requested. On 10/23/25 LPA Flores contacted administrator and delivered findings.

(CONTINUED ON LIC 9099C)
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
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-20250729094110
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: TERRACES AT PARK MARINO, THE
FACILITY NUMBER: 197602744
VISIT DATE: 10/23/2025
NARRATIVE
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During the course of this investigation, it was found that the alleged victim did not reside or was a potential resident at the facility based on interview conducted with administrator and document review revealed resident roster received on 1/9/25 and on 8/7/25 does not list alleged victim as a resident. There are no records that indicate alleged victim resided at the facility prior to 1/8/25.

This agency has investigated the complaint alleging Resident received unexplained injury due to neglect. We have found that the complaint was UNFOUNDED, meaning that the allegation was false, could not have happened and/or is without reasonable basis. We have therefore dismissed the complaint.

Exit interview was conducted with Maria Quizon via telephone a copy of this report was email to administrator for signature.
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Mary G Flores
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2