198204374-3-27-2025-28-AS-RORN-DFDU7F-20250403151953

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198204374
Report Date: 03/27/2025
Date Signed: 03/27/2025 12:58:29 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
03/21/2025 and conducted by Evaluator Tena Herrera

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250321151323

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: 14	DATE:	03/27/2025
		UNANNOUNCED	TIME BEGAN:	09:34 AM
MET WITH:	Jennifer Bobadilla - Administrator		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Staff coerced resident in receiving hospice care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced complaint visit to investigate the above allegation. LPA was greeted by Champa (caregiver) and the reason for the visit was explained, shortly after Administrator Jennifer Bobadilla arrived to assist with the visit.

The investigation consisted of the following:
LPA obtained copies of staff and client rosters, documents within Resident #1's (R1) file that are relevant to complaint, interview with Administrator, Witness #1 (W1), and 3 Residents.

(Continued on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2025

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-20250321151323

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: 03/27/2025

NARRATIVE

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The investigation revealed the following:
Allegation: Staff coerced resident in receiving hospice care.
It is alleged that staff have persuaded R1 in signing up with hospice care and they did so unwillingly. LPA interviewed Administrator and it was explained that R1 did give some push back on enrolling into hospice care but after speaking with family and R1 it was determined hospice care was the best fit for R1. Administrator confirmed that alternatives were also provided to R1 but ultimately R1 decided to be admitted to facility with the hospice care services. LPA interviewed W1 and it was confirmed that all information and alternatives were provided to R1 and although R1 was not happy about signing up for hospice services they ultimately decided to sign up on their own. LPA interviewed R1 and R1 stated that although they are not happy about signing up for hospice care they understand why it was suggested and fit for them. LPA interviewed 2 additional residents whom receive hospice care and both denied the above allegation, stating they willingly signed up for hospice and had no influence from staff on their decision.

Based on statements and interviews conducted with staff and residents, and review of resident files, there was not enough supportive evidence to concur with the reported 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.

Exit interview held, and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/27/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/27/2025

LIC9099 (FAS) - (06/04)

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