198204374-10-20-2025-28-AS-LHIS-DN3NU6-20251103094547

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198204374
Report Date: 10/20/2025
Date Signed: 10/20/2025 01:50:16 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
10/16/2025 and conducted by Evaluator Alberto Lopez

COMPLAINT CONTROL NUMBER: 28-AS-20251016133034

FACILITY NAME:	SIMLA VILLAS INC.		FACILITY NUMBER:	198204374
ADMINISTRATOR:	SIMLA MEHTA		FACILITY TYPE:	740
ADDRESS:	16623 ARDMORE AVENUE		TELEPHONE:	(562) 804-3603
CITY:	BELLFLOWER	STATE: CA	ZIP CODE:	90706
CAPACITY:	15	CENSUS: 12	DATE:	10/20/2025
		UNANNOUNCED	TIME BEGAN:	10:13 AM
MET WITH:	Jennifer Bobodilla, Administrator		TIME COMPLETED:	01:49 PM

ALLEGATION(S):

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Licensee is retaining a resident with a higher level of care need.
Licensee is not ensuring that resident's medical needs are being met while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alberto Lopez made initial visit to investigate the above allegations. LPA met with Administrator Jennifer Bobadilla and discussed the purpose of the visit.

The investigation consisted of LPA taking tour of facility, obtaining and reviewing staff and resident rosters, R1 Face sheet, Physicians Report for the elderly dated 02/20/2025, and admission agreement. LPA reviewed needs and services and asked facility to send LPA a copy.
The investigation revealed regarding allegation: Licensee is retaining a resident with a higher level of care need. It is alleged that facility is retaining R1 that requires a higher level of care. LPA interviewed eight (8) residents and seven (7) of eight (8) residents could not corroborate the allegation. LPA interviewed four (4) staff and three (3) of four (4) staff denied the allegation. R1 stated that R1 gets good care, that R1 room and bed are changed and R1 gets food and R1 body and hair are kept clean. R1 stated that R1 is just tired of being at facility and would like to go to live with ralative. R1 stated R1 has no issues with facility. R1 stated R1 does not need higher level of care. (continued on 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025

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-20251016133034

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: SIMLA VILLAS INC.	FACILITY NUMBER: 198204374
	VISIT DATE: 10/20/2025

NARRATIVE

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(continued from 9099)
LPA reviewed R1 Physicians report, and it does not show R1 needing higher level of care. R1 stated she sees fine, not blurry and can read without glasses. There is insufficient evidence to support this allegation.

Allegation: Licensee is not ensuring that resident's medical needs are being met while in care. It is alleged that facility is not providing client access for dental, and vision care. LPA interviewed eight (8) residents, and seven (7) of eight (8) residents could not corroborate the allegation. LPA interviewed four (4) staff, and all four (4) staff denied the allegation. Several staff stated that they provide for R1 needs. Staff stated that if R1 requires dental or optometrist visit, that they help arrange it for R1. Staff stated that responsibility would fall on the power of attorney (POA). However, admission agreement shows that facility would assist R1 with assistance in meeting necessary medical and dental appointments. Facility would encourage responsible party to transport R1 but would transport if responsible party is not available. R1 has not gone to see a dentist since R1 was admitted seven (7) years ago but staff stated dentist made home visit about two (2) years ago. R1 stated to LPA that R1 does not want to see a dentist now and R1 will let facility know when R1 wishes to see dentist. R1 stated R1 has no pain, discomfort or sensitivity to cold and hot liquids at this time. LPA reviewed R1 physician’s report, and it does not show that R1 needs glasses. R1 stated R1 sees fine, not blurry and can read without glasses. R1 has right to refuse dental services. There is insufficient evidence to support this allegation.

Based on statements and interviews conducted with staff and residents, tour of facility and review of facility file records, there was not enough supportive evidence to concur with the reported allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview held, and a copy of this report was provided.

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025

LIC9099 (FAS) - (06/04)

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