197606170-10-16-2025-11-AS-UCOL-DN7TEY-20251107134043

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197606170
Report Date: 10/16/2025
Date Signed: 10/16/2025 03:30:00 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
09/12/2025 and conducted by Evaluator Regina Cloyd

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20250912153247

FACILITY NAME:	GOLDEN MANOR REST HOME		FACILITY NUMBER:	197606170
ADMINISTRATOR:	MARK INGBER		FACILITY TYPE:	740
ADDRESS:	3535 OVERLAND AVENUE		TELEPHONE:	(310) 836-0510
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90034
CAPACITY:	98	CENSUS: 60	DATE:	10/16/2025
		UNANNOUNCED	TIME BEGAN:	02:22 PM
MET WITH:	Maggie Romero		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff are financially abusing residents.

INVESTIGATION FINDINGS:

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On 10/16/2025, Licensing Program Analyst (LPA) Regina Cloyd conducted an subsequent visit to gather information regarding the above allegation. LPA met with Staff Maggie Romero and spoke with Assistant Administrator Judith Muro over the phone and the purpose of the visit was explained.

Investigation consisted of the following: On 09/19/2025, LPA obtained Personnel Report (dated 04/16/25), Register of Residents (04/23/25), Resident Theft and Lost Record (Rev. 10/89), R1’s Receipt (04/14/25), R1’s Resident Statement and Acknowledgement document (signed 04/14/25) and R1’s Unusual Incident Report (dated occurred 04/14/25). LPA interviewed Staff #1 – 9 and Residents #1 – 8. On 10/16/25, LPA interviewed Staff #10 and reviewed one resident’s record. Note: Resident #9 declined to be interviewed.

Continue to LIC9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2025

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 11-AS-20250912153247

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: GOLDEN MANOR REST HOME	FACILITY NUMBER: 197606170
	VISIT DATE: 10/16/2025

NARRATIVE

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Investigation revealed the following:

Allegation: Staff are financially abusing residents.

Regarding the allegation, “Staff are financially abusing residents,” it is being alleged that Staff #1 (S1) has stolen money from R1, R5 – R8. It is being alleged that Staff #10 (S10) and other staff members has taken money from residents’ rooms and possibly their mail.

Review of incident report (04/14/25) revealed R1 reported lost money and staff helped R1 look for it but could not find it. Review of receipt revealed the facility paid R1 $2,000.00 on 04/14/2025. The Administrator, S1, and S10 indicated that R1 has been the only resident to complain about staff stealing money. W1 was aware of R1’s complaint and indicated that the Administrator would reimburse R1. Four out of seven staff interviews (S3 – S9) indicated that residents have not complained lost or stolen money. Five out of eight resident interviews (R1 – R8) indicated that they have not had money lost or stolen. R5 indicated that money went missing when R5 went to the emergency room, it was reported to the office, and R5 was redirected to follow up with Veterans Affairs but did not. S10 indicated that R5 has not complained about lost money. R6 – R8 denied the allegation.

Regarding the allegation, “Staff are financially abusing residents,” based on record review and interviews, 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.

An exit interview was conducted with Judith Muro over the phone, technical assistance provided, and a copy of this report was provided to Office Staff Maggie Romero.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2025

LIC9099 (FAS) - (06/04)

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