<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197607966
Report Date: 05/23/2025
Date Signed: 05/23/2025 11:12:31 AM

Unfounded


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
05/22/2025 and conducted by Evaluator Alfonso Iniguez
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20250522115831
FACILITY NAME:VETERANS HOME OF CALIFORNIA - WEST LOS ANGELESFACILITY NUMBER:
197607966
ADMINISTRATOR:DEVON YOUNGFACILITY TYPE:
740
ADDRESS:11500 NIMITZ AVENUETELEPHONE:
(424) 832-8200
CITY:LOS ANGELESSTATE: CAZIP CODE:
90049
CAPACITY:84CENSUS: 59DATE:
05/23/2025
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Marnell Banks/Resident Care Specialist.TIME COMPLETED:
11:10 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not preventing resident from being molested while in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 5/23/2025 at approximately 8:30 AM, LPA Alfonso Iniguez conducted an unannounced complaint visit. LPA Iniguez met with Marnell Banks/Resident Care Specialist. LPA Iniguez explained the purpose of this visit.

Investigation Consisted of: LPA Iniguez conducted the following interviews: Resident Care Specialist (A#1), Standards and Compliance Manager (S#1) and Residents Interviews (R#1-R#7). LPA obtained and reviewed the following documents: Resident Roster dated: 5/23/25 and Personnel Report or LIC 500 dated:5/23/2025.



Evaluation Report continues LIC 9099-C
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2025
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 11-AS-20250522115831
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: VETERANS HOME OF CALIFORNIA - WEST LOS ANGELES
FACILITY NUMBER: 197607966
VISIT DATE: 05/23/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Investigation Revealed the Following:

Allegation: Staff are not preventing resident from being molested while in care.

The details of the complaint alleged that (R#1)’s observed their roommate been observed by unknown individual.



On May 23, 2025, at approximately 9:30 AM, during the records review, LPA Iniguez observed the Resident’s Roster dated 5/23/25. (R#1) is not listed in the roster.

On May 23, 2025, at approximately 10:00 AM, during an interview with facility staff (A#1 and S#1), (2) out of (2) stated that (R#1) does not live here and never did.

On May 23, 2025, at approximately 10:30 AM, LPA Iniguez was not able to interview (R#1) since they never resided at the facility.

On May 23, 2025, at approximately 10:30 AM, during an interview with facility residents (R#2-R#7), (6) out of (7) stated that they had never seen or heard about (R#1) living at the facility.

Unfounded: This agency has investigated the complaint alleging (Staff are not preventing resident from being molested while in care). 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.

An exit interview was conducted, and a copy of the Complaint Report was given to Marnell Banks/Resident Care Specialist.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Alfonso Iniguez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2