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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197800743
Report Date: 01/26/2022
Date Signed: 01/26/2022 11:07:04 AM

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
12/28/2021 and conducted by Evaluator Tony Vasallo
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20211228113836
FACILITY NAME:CASITAS TRANQUILASFACILITY NUMBER:
197800743
ADMINISTRATOR:LISA MAHERFACILITY TYPE:
772
ADDRESS:11921,23,25,27,29 ELLIOTT AVE.TELEPHONE:
(626) 350-5304
CITY:EL MONTESTATE: CAZIP CODE:
91732
CAPACITY:15CENSUS: 11DATE:
01/26/2022
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Lisa Maher, AdministratorTIME COMPLETED:
11:20 AM
ALLEGATION(S):
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Unlawful eviction
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Vasallo conducted a subsequent complaint visit. LPA met with Administrator, Lisa Maher and explained the reason for the visit. The initial complaint visit was conducted by LPA Tao on 1/4/22.

The investigation consisted of the following: Client #1's (C1's) file was reviewed. Administrator was interviewed and Client #2 (C2) was interviewed. The physical plant was toured.

The investigation revealed the following: It's alleged C1 was unlawfully evicted. Incident reports involving C1 were reviewed. On 11/18/21, C1 was involved in a physical altercation with C2. C1 allegedly confronted C2 about property that C2 may have taken from C1's room. C1 attacked C2 and a physical altercation occurred. Police were called, but no arrest were made. Police did find a gun in C1's room. Allegedly the gun was a BB gun. C1 was given a 30-day notice for breaking the house rules. On 12/31/21, C1 went to C2's room and threatened violence again. C1 was relocated the next day by has case manager from Pacific Clinics.
Continued on 9099C.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Tony Vasallo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2022
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 28-AS-20211228113836
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: CASITAS TRANQUILAS
FACILITY NUMBER: 197800743
VISIT DATE: 01/26/2022
NARRATIVE
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C2 was interviewed and confirmed the altercation with C1. C2 denies ever taking anything from C1. LPA attempted to interview C1, but C1 did not return LPA's calls. The 30 day notice was reviewed. The notice explains why C1 is being evicted and does give 30 days notice to vacate. The notice is also signed by C1. C1 stayed longer than 30 days after receiving the notice. Based on the information obtained, the allegation is unsubstantiated.

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 held. A copy of the report was provided.
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Tony Vasallo
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2