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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320294
Report Date: 01/24/2025
Date Signed: 01/24/2025 03:16:49 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, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/17/2025 and conducted by Evaluator Socorro Leandro
COMPLAINT CONTROL NUMBER: 11-AS-20250117102207
FACILITY NAME:ACTIVE CARE HOME 1FACILITY NUMBER:
198320294
ADMINISTRATOR:CANTORIA, MARIA L.FACILITY TYPE:
735
ADDRESS:20545 MADISON ST.TELEPHONE:
(310) 370-3748
CITY:TORRANCESTATE: CAZIP CODE:
90503
CAPACITY:4CENSUS: 4DATE:
01/24/2025
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH: Administrator - Kadiguia LinayaoTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Uncleared adult(s) present in the facility
Facility staff did not prevent physical altercations between residents
INVESTIGATION FINDINGS:
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On 01/24/2025, the Department of Social Services (DSS) - Community Care Licensing Division (CCLD) staff conducted an unannounced complaint visit at this facility. CCLD staff was greeted by Administrator, Kadiguia Linayao.

The investigation consisted of the following: 4 out of 4 clients were interviewed; 4 out of 4 staff were interviewed; client, staff, and facility records were reviewed.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2025
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-20250117102207
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: ACTIVE CARE HOME 1
FACILITY NUMBER: 198320294
VISIT DATE: 01/24/2025
NARRATIVE
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The investigation revealed the following:

Regarding the allegation “Uncleared adult(s) present in the facility”, it is being alleged that adults who are not finger print cleared are working in the facility and/or are present in the facility. Records reviewed revealed the following: Personnel Report, Staff Schedule for December 2024 and January 2025, and the departments list of Cleared Personnel indicate that all staff members are cleared to work at this facility. Interviews conducted revealed the following: 4 out of 4 staff denied the allegation. Regarding the allegation, the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the allegation is unsubstantiated.

Regarding the allegation “Facility staff did not prevent physical altercations between residents”, it is being alleged that facility staff do not prevent (mitigate) physical altercations between clients in care. Interviews conducted revealed the following: 4 out 4 clients denied the allegation and 4 out of 4 staff denied the allegation. Observations revealed the following: CCLD staff observed staff using de-escalation methods with clients in care. Regarding the allegation, the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the allegation is unsubstantiated.

An exit interview was conducted, and a copy of this report was left with the Administrator.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:

DATE: 01/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2