197608408-6-23-2026-28-AS-WSHO-DVUUN6-20260710154326

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608408
Report Date: 06/23/2026
Date Signed: 06/23/2026 05:05:09 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
05/29/2026 and conducted by Evaluator Nune Margaryan

COMPLAINT CONTROL NUMBER: 28-AS-20260529125412

FACILITY NAME:	3RD AVENUE		FACILITY NUMBER:	197608408
ADMINISTRATOR:	CARLTON COOK		FACILITY TYPE:	735
ADDRESS:	1247 3RD AVENUE		TELEPHONE:	(323) 935-9454
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90019
CAPACITY:	6	CENSUS: 4	DATE:	06/23/2026
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Damon Robinson		TIME COMPLETED:	05:15 PM

ALLEGATION(S):

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Staff did not prevent resident from being sexually abused.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nune Margaryan conducted an unannounced subsequent complaint inspection visit regarding the above-mentioned allegation. LPA met with Assistant Administrator Damon Robinson and explained the purpose of the visit.
On 06/01/2026, LPA Nune Margaryan conducted the initial unannounced health and safety check visit at the facility. During the visit, LPA toured the facility, obtained copies of staff and clients rosters, and reviewed and collected documents relevant to the complaint investigation. At the time of the visit, Client 1 (C1) and Client 2 (C2) were attending the Day Program, Client 3 (C3) was hospitalized, and Client 4 (C4) was at a skilled nursing facility (SNF) for rehabilitation following the surgery. LPA did not observe any immediate health and safety concerns during the visit.
On 06/11/2026, a subsequent visit was conducted by the Department. During the visit, C1 was interviewed.
During today’s visit, LPA interviewed Assistant Administrator, Staff 1 - Staff 3, Client 2 (C2). LPA was unable to interview C3 and C4, as C3 remained hospitalized and C4 remained at the SNF for rehabilitation.
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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2026

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 28-AS-20260529125412

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: 3RD AVENUE	FACILITY NUMBER: 197608408
	VISIT DATE: 06/23/2026

NARRATIVE

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Allegation: Staff did not prevent client from being sexually abused. It was alleged that an individual entered Client 1’s room at night and engaged in non-consensual sexual acts with C1, specifically anal penetration without consent. C1 reported name “Den Den” in connection with the allegation.

Interviewed Assistant Administrator stated that on 05/26/26, facility staff participated in a routine telephone call with C1’s conservator regarding C1’s care. During the conversation, the conservator reported that C1 may have previously informed a crisis support counselor that an individual had entered C1’s room at night and sexually assaulted them. The Administrator stated this was the first time facility staff became aware of any such allegation. Upon learning of the allegation, Assistant Administrator immediately contacted Frank D. Lanterman Regional Center to report on the concern. Assistant Administrator further stated that staff were interviewed to determine whether anyone had witnessed concerning incidents or heard statements regarding sexual abuse. No staff members reported witnessing any incident involving C1 or hearing C1 make statements alleging sexual abuse. LPA interviewed staff S1 - S3. interviews revealed that no one, including C1, had reported concerns regarding sexual abuse to them. All staff interviewed stated they had not observed any unauthorized individuals entering C1’s room or any other client’s room. Assistant Administrator and staff reported that C2 frequently watches Anime, including a series titled Dan Da Dan.“Dan Da Dan” is a fictional character associated with the Anime. It was noted that the series contains intense supernatural themes, strong language, and references to sexual assault and based on information, it is possible that C1’s comments were influenced by exposure to this media content. Review of C1’s Individual Program Plan (IPP) indicates that C1 is able to communicate verbally using words; however, it has been observed that C1 frequently engages in conversations with individuals not visible to others. Record review further indicates that C1 has documented mental health needs requiring ongoing psychiatric care. On 06/03/26 the LAPD responded to the home to conduct a welfare check on C1. Officer Vasquez arrived at the facility at 2:30 PM and departed at 2:40 PM. The officer spoke with C1 in private and left without any reportable concerns. Assistant Administrator reported that Frank D. Lanterman Regional Center conducted an investigation on 05/29/26. They conduct interviews and review documentation as appropriate. A final planning meeting was held on 06/04/26 to discuss the investigation findings. Based on the information gathered through statements, the allegation was unsubstantiated.

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SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2026

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20260529125412

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: 3RD AVENUE	FACILITY NUMBER: 197608408
	VISIT DATE: 06/23/2026

NARRATIVE

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During interview, C1 stated that facility staff treat them and the other clients well and that they like the staff. C1 reported no complaints or concerns. C1 did not disclose any abuse and, when asked directly whether anyone had harmed or abused them in any way, responded, “No.” C1 denied being sexually abused by anyone at the facility. C1 further stated that they have a good relationship with staff, feel safe at the facility, and denied any incidents of sexual abuse. Interviews with C2 revealed no knowledge or observations of sexual abuse involving C1 or any other client. They stated that they feel safe, well cared for, and comfortable residing at the facility. Based on statements and interviews conducted with clients and staff as well as reviewed files and documentation, there was not enough supportive evidence to corroborate the allegation.

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

Exit interview conducted and copy of report was provided to Assistant Administrator Damon Robinson.

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2026

LIC9099 (FAS) - (06/04)

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