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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608604
Report Date: 05/18/2026
Date Signed: 05/18/2026 11:26:47 AM

Unsubstantiated


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
12/23/2025 and conducted by Evaluator Luis DeLeon
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251223110449
FACILITY NAME:PROMISE ASSISTED LIVING, LLC.FACILITY NUMBER:
197608604
ADMINISTRATOR:GREGORY Z. RESTUMFACILITY TYPE:
740
ADDRESS:1231 SOUTH ALVARADO STREETTELEPHONE:
(310) 205-2591
CITY:LOS ANGELESSTATE: CAZIP CODE:
90006
CAPACITY:22CENSUS: 22DATE:
05/18/2026
UNANNOUNCEDTIME BEGAN:
10:29 AM
MET WITH:Administrator Gregory RestumTIME COMPLETED:
11:40 AM
ALLEGATION(S):
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Staff neglect resulted in a resident sustaining multiple pressure injuries
Staff did not prevent a resident from physically assaulting other residents

INVESTIGATION FINDINGS:
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On todays visit, Licensing Program Analyst (LPA) Luis De Leon conducted a subsequent unannounced complaint investigation visit for the allegations listed above and to deliver findings. LPA met with Administrator Gregory Restum and explained the reason for the visit.

On 12/24/25, LPA DeLeon conducted the initial complaint visit, during visit, LPA toured the physical plant with S1, obtained the current resident and staff roster, relevant documents pertaining to residents 1 (R1).
On 04/09/2026, LPA DeLeon conducted a subsequent complaint visit and obtained additional documents including staff and resident roster, facility’s hospice care policy, R1’s hospice care plan and R1’s hospice care notes.
On 05/01/2026, LPA DeLeon conducted a subsequent compliant visit and obtained additional documents, R1’s hospice treatment instructions for hospice visit on 12/16/2025 and facility R1’s Medication Administration Record (MAR). LPA interviewed seven (7) residents and six (6) staff.
(Report continues on page LIC-9099C...)
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Luis DeLeon
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2026
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
Control Number 28-AS-20251223110449
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: PROMISE ASSISTED LIVING, LLC.
FACILITY NUMBER: 197608604
VISIT DATE: 05/18/2026
NARRATIVE
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Regarding allegation: Staff neglect resulted in a resident sustaining multiple pressure injuries.
It is alleged that staff did not provide a resident with adequate care, which led to the resident developing several pressure injuries. The investigation consisted of interviews with staff, residents, and review of R1 facility files including discharge hospital records and hospice care plan. The investigation reveals the following: R1 was admitted to the facility on 08/20/2025 with no wounds and R1 was admitted to Hospice on 08/21/2025. Review of R1s facility records revealed that R1 had a hospital visit on 12/05/2026, and there are no documents indicating that R1 had developed a pressure injury on 12/05/2026. On 12/16/25, R1s hospice records revealed that R1’s hospice attending nurse documented it was observed that R1 had a new onset Stage II to Upper Coccyx. Hospice Nurse provided staff with instructions to staff to care for R1’s wounds, which included cleaning, medication, and re-positioning. On 12/21/2025, R1 was sent to the hospital for shortness of breath. R1’s hospital discharge records dated 12/23/26 indicated that R1 had developed lower back unstageable pressure injury to lower back. R1s Facility Medication Administration Record (MARs) for the month of December 2025 revealed that the facility implemented and followed R1s hospice wound care plan beginning December 16, 2025, which included staff repositioning R1 every two (2) hours, cleaning wound, and applying medication. The facility MARs indicated that staff provided followed R1’s wound care until R1 was sent to the hospital on 12/20/2025. Interview with residents revealed that six (6) out of eight (8) residents were not aware of any resident bedbound to have developed any wounds from being in bed or on wheelchair. Interviews with staff revealed that six (6) out of six (6) staff were not aware of the above allegation. Staff indicated that R1 spent most of the day in the wheelchair. Staff stated that staff assisted R1 with repositioning in wheelchair and at bed when R1 was awake. Staff assisted R1 with transferring from bed to wheelchair whenever R1 requested transfer assistance. Based upon the investigation, resident and staff interviews, document review, and LPA observations, there is no evidence to support the allegation that facility’s neglect caused R1 developing pressure injuries.

Regarding allegation: Staff did not prevent a resident from physically assaulting other residents.
It is alleged that facility staff did not take action to prevent a resident assaulting another resident in care. Investigation consisted of interviews with staff, residents, and review of resident #1 (R1) and resident #7 (R7) facility files, including admission agreement and physician’s report. The investigation revealed the following: Interviews with six (6) out eight (8) residents revealed that residents denied being assaulted at facility and residents denied knowing of other residents being assaulted at the facility.
(Report continues on page LIC-9099C...)
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Luis DeLeon
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20251223110449
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: PROMISE ASSISTED LIVING, LLC.
FACILITY NUMBER: 197608604
VISIT DATE: 05/18/2026
NARRATIVE
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Residents stated that residents have not witnessed any residents arguing with each other and that residents get along with one another. LPA interviewed resident #1 (R1), R1 stated that staff do not take action to prevent R7 from verbally or physically assaulting other residents. R1 stated that R7 has assaulted R1 and that R7 has threatened to hurt other residents. R1 stated that R7 has hit R1 with close fist on the face. However, R1 later stated that R7 didn’t hurt bad but would strike using his knuckles closed fist. Interview with R7 revealed that R7 denied assaulting R1. Staff did not intervene since there was no incident between R1 and R7. Interview with five (5) out of six (6) staff revealed that staff are not aware of any residents assaulting other residents in care. One (1) out of six (6) staff stated to be aware of a resident attempting to assault another resident. Staff intervened, reported the incident to local law enforcement and the resident is no longer residing at the facility, after said incident. Staff interviewed described R7 as being calm and as peacekeepers when conflicts between residents arise. Staff stated that R7 personality is loud, but staff are not aware of R7 assaulting any facility residents. S1 indicated that staff re-direct residents before any conversation may escalate to assault. Staff separates residents and discusses with residents the matter that caused the residents’ disagreement. S1 stated that no resident has touched or put a finger on other residents at the facility. The investigation did not reveal that residents are assaulting other residents and revealed that staff take action to prevent residents from assaulting other residents. Based upon the investigation, resident and staff interviews, document review, and LPA observations, there is no evidence to support the allegation that staff is not preventing residents from assaulting other residents.

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.

Exit interview held with Administrator Gregory Restum. A copy of the report was provided.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Luis DeLeon
LICENSING EVALUATOR SIGNATURE:

DATE: 05/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3