197608120-3-17-2026-31-AS-MGFS-DTEVFR-20260423162422

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608120
Report Date: 03/17/2026
Date Signed: 03/17/2026 03:19:02 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/13/2026 and conducted by Evaluator Leslie Ngo-Castaneda

COMPLAINT CONTROL NUMBER: 31-AS-20260313104145

FACILITY NAME:	CCLE HOME CARE, LLC		FACILITY NUMBER:	197608120
ADMINISTRATOR:	ROSANNA TOMENENG		FACILITY TYPE:	735
ADDRESS:	16055 NAPA STREET		TELEPHONE:	(818) 830-7383
CITY:	NORTH HILLS	STATE: CA	ZIP CODE:	91343
CAPACITY:	4	CENSUS: 4	DATE:	03/17/2026
		UNANNOUNCED	TIME BEGAN:	11:20 AM
MET WITH:	Josephine Dangzalan- designee		TIME COMPLETED:	03:40 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not answer clients call for help
Staff did not provide adequate care and supervision to client
Staff do not ensure transportation for clients
Staff do not ensure clients attend medical appointments.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an unannounced initial visit for the above allegation. LPA met with staff designee (S2), Josephine Dangzalan and explained the reason for the visit. At 11:30 AM licensee, Rosanna Tomeneng, arrived and was explained the reason of the visit.

LPA took a tour of the physical plant at 11:25AM. At 11:50 AM, LPA interviewed the licensee (S1) and staff designee (S2). At 11:41 AM, LPA interviewed a total of four (4) residents. At 12:30 PM LPA conducted a records review of C1's file, as well as other relevant documents, including the physician's report, admission agreement, LIC 500 (staff roster), resident roster (LIC 9020), Individual Program Plan (IPP), and other pertinent documents.

Allegation: Staff did not answer client’s call for help.

Continue to LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026

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 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME:	FACILITY NUMBER:
	VISIT DATE: 03/17/2026

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

It is alleged that facility staff do not assist clients when assistance is requested. Interview with the licensee and staff designee, revealed that staff respond immediately when clients call. Staff explained that clients who require assistance or attention are immediately attended to, and assistance is provided continuously throughout the day and night. All of the clients stated that staff provide assistance as requested immediately.

Based on interviews and record reviews, there is no sufficient information to verify the allegation. Therefore, the allegation is unsubstantiated at this time.

Allegation: Staff did not provide adequate care and supervision to client.

It is alleged that client was left unattended in the bathroom. Staff interviews revealed that when C1 was screaming in the bathroom at around 11pm, staff responded to C1 who was in the bathroom. Clients’ interviews revealed that staff were at the facility available and assisted C1 in the bathroom. Per clients staff always provide adequate care and supervision at the facility. A review of incident report dated: 1.7.2026 submitted to the Department confirmed staff statements.

Based on interviews and record reviews, there is no sufficient information to verify the allegation. Therefore, the allegation is unsubstantiated at this time.

Allegation: Staff do not ensure transportation for clients.

It is alleged that there is no transportation to take the clients home at night. Interviews with staff members state that transportation is provided to clients by using the facility’s car. The facility’s car is used to run errands and take clients to their medical appointments. Staff also stated that C1 has not asked for transportation assistance and that staff and licensee are available to transport C1 as needed. Interview with one client (C1) revealed that they never asked facility staff for assistance in transportation. Interview with clients reveal that transportation is available to them when requested at any time.

Based on interviews and record reviews, there is no sufficient information to verify the allegation. Therefore, the allegation is unsubstantiated at this time.

Continue to LIC 9099-C

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20260313104145

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: CCLE HOME CARE, LLC	FACILITY NUMBER: 197608120
	VISIT DATE: 03/17/2026

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

Allegation: Staff do not ensure clients attend medical appointments

It is alleged that staff did not ensure C1 attended their medical appointments. Staff interviews revealed that licensee (S1) schedules the clients’ medical appointments and transport them to medical appointments as well. Record review revealed appointments are scheduled for C1 and it is noted C1 has refused to attend their medical appointments. Interviews with clients reveal that they attend their medical appointments and staff schedule them and taken them to their appointments. Interview with C1 reveal that staff schedule and encourage C1 to go to their medical appointments.

Based on interviews and record reviews, there is no sufficient information to verify the allegation. Therefore, the allegation is unsubstantiated at this time.

No health and safety issues noted at the time of this visit.

An exit interview was conducted, and a copy of the report was provided.

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 3