197609014-10-8-2025-31-AS-NMAN-DMJMTH-20251017095332

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609014
Report Date: 10/08/2025
Date Signed: 10/08/2025 11:29:35 AM

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
02/20/2025 and conducted by Evaluator Antonia Alvizar-Ettima

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20250220115427

FACILITY NAME:	EL MOLINO MANOR		FACILITY NUMBER:	197609014
ADMINISTRATOR:	PASCASIO, GLORIE		FACILITY TYPE:	735
ADDRESS:	2544 N EL MOLINO AVENUE		TELEPHONE:	(626) 639-4270
CITY:	ALTADENA	STATE: CA	ZIP CODE:	91001
CAPACITY:	36	CENSUS: 0	DATE:	10/08/2025
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Rosario Ayala, Direct Support Professional (DSP)		TIME COMPLETED:	11:40 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility did not ensure an emergency disaster plan was in place

INVESTIGATION FINDINGS:

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

Due to the destruction of El Molino Adult Residential by Eaton fire, the associated complaint report was delivered to Nelville Guest Home-Washington, a property under the same ownership. Licensing Program Analyst (LPA) Antonia Alvizar-Ettima met with DSP and disclosed the purpose of the visit. DSP contacted Administrator, Zonel Pascacio via-phone. Administrator granted permission for DSP to sign the report on his behalf.

It was alleged that facility did not ensure an emergency disaster plan was in place and followed. The staff #1 (S1) informed clients that they needed to evacuate. However, no other instructions were provided. Client #1 (C1) and their roommate got into C1’s care and drove to Pasadena Civic Center.
To investigate the allegation, on 02/25/25 due to circumstances surrounding Eaton Fire-Disaster, LPA and Licensing Program Manager (LPM), Naira Margaryan conducted an initial virtual visit. Virtual tour of the facility was not conducted due to the facility burning down to the ground. LPA and LPM spoke with the
Cont. on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2025

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 31-AS-20250220115427

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: EL MOLINO MANOR	FACILITY NUMBER: 197609014
	VISIT DATE: 10/08/2025

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

Cont. from LIC9099

Administrator and gathered information pertinent to allegation. The Administrator indicated that Staff #1 (S1) was awake when the Sheriff Department spoke over a loudspeaker telling staff and clients to evacuate the facility.

S1 immediately informed the Administrator. While S1 started evacuation process and told all clients to gather in front of the facility, the Administrator and staff #2 (S2) arrived and went to check all bedrooms to make sure no clients were left behind. They gathered medication, clothes and transported clients to the Pasadena Convention Center. On 09/18/2025, at 4:00p.m., LPA and LPM conducted via phone interview with staff #2 (S2) regarding the allegation. Information revealed ,from S2 supported the statement received from the Administrator. On 10/06/25 at about 3:00p.m., LPA contacted Administrator via-phone again, attempting to obtain contact information for staff #1 (S1), but not available. In addition, LPA made an attempt to obtain a contact phone numbers for facility clients. However, due to fire and emergency relocation no contact information was available. On 10/06/25 LPA reviewed facility file and available documentation and confirmed that an approved Emergency Disaster Plan was on file. The information revealed from the document corroborated the information received from interviews.

Based on interviews and record review, it was concluded that although the alleged incident may have happened, there is insufficient information to confirm that “Facility did not ensure an emergency disaster plan was in place”. Therefore, the allegation was deemed UNSUBSTANTIATED at this time.

No health and safety hazards were noted during this visit.

Exit interview conducted/copy of report provided.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:	DATE: 10/08/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/08/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 2