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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608888
Report Date: 11/20/2025
Date Signed: 11/20/2025 03:38:04 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
11/13/2025 and conducted by Evaluator Elvira Gonzalez
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20251113111817
FACILITY NAME:WEST PICO TERRACE ASSISTED LIVING CENTER LPFACILITY NUMBER:
197608888
ADMINISTRATOR:CHRISTOPHER,MELISSAFACILITY TYPE:
740
ADDRESS:6050 W PICO BLVDTELEPHONE:
(323) 653-5565
CITY:LOS ANGELESSTATE: CAZIP CODE:
90035
CAPACITY:136CENSUS: 90DATE:
11/20/2025
UNANNOUNCEDTIME BEGAN:
08:08 AM
MET WITH:Azucena ReyesTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Staff threatened resident.
INVESTIGATION FINDINGS:
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On 11/20/25, Licensing Program Analyst (LPA) Elvira Gonzalez conducted an unannounced complaint visit to investigate the above mentioned allegation. LPA met with Administrator, Azucena Reyes, and explained the purpose of the visit. LPA was granted entry to the facility.

The investigation consisted of the following: On 11/20/25, the following documents were reviewed and obtained as part of the investigation: staff roster, resident roster. LPA reviewed resident #1's service records and obtained copies of the follwing documents: Physician's Report, Admission Agreement, Admission Record, House Rules, and Personal Rights. Additionally, LPA Gonzalez interviewed staff #1-#4 (S1-S4), and residents #1-#8 (R1-R8).


Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2025
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-20251113111817
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: WEST PICO TERRACE ASSISTED LIVING CENTER LP
FACILITY NUMBER: 197608888
VISIT DATE: 11/20/2025
NARRATIVE
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The investigation revealed the following:

Allegation: Staff threatened a resident. It is being alleged that a staff member told a resident “We gotta get you out of here”. It is also being alleged that in the past, a staff member told a resident that they’re on their radar”. On 11/20/25, LPA Gonzalez conducted interviews with S1–S4. Of those interviewed, 4 out of 4 staff could not corroborate with the allegation. 4 out of 4 staff said they treat all residents with dignity and respect. During the interview, Administrator, Azucena Reyes told LPA Gonzalez that she did have a conversation with R1 regarding their behavior and an incident with R2.

On 11/19/25, LPA Gonzalez interviewed R1–R8. Of those interviewed, 8 out of 8 residents could not corroborate with the allegation. 7 out of 8 residents said that staff treat them with dignity and respect, and 1 out of 8 residents said staff does not treat them with dignity and respect.

Based on interviews conducted, and records reviewed, there is insufficient evidence to support 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.

No deficiencies were cited during this investigation.


An exit interview was conducted, and a copy of the report was provided to Azucena Reyes.
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2