198320387-9-11-2025-11-AS-SCIS-DMA29U-20251008171232

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320387
Report Date: 09/11/2025
Date Signed: 09/11/2025 09:56:56 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/03/2025 and conducted by Evaluator Troy Watson

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20250603151412

FACILITY NAME:	LACONIA HOME		FACILITY NUMBER:	198320387
ADMINISTRATOR:	RONQUILLO, SHYRIL		FACILITY TYPE:	734
ADDRESS:	611 W LACONIA BLVD		TELEPHONE:	(714) 519-8997
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90044
CAPACITY:	5	CENSUS: 5	DATE:	09/11/2025
		UNANNOUNCED	TIME BEGAN:	09:26 AM
MET WITH:	GUSTAVO NARANJA - HOUSE MANAGER		TIME COMPLETED:	09:56 AM

ALLEGATION(S):

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Staff do not ensure resident oxygen tanks are operable.
Staff do not treat resident's with dignity or respect.
Residents are not given privacy in their living space.

INVESTIGATION FINDINGS:

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On 09/11/25 Licensing Program Analyst (LPA) Troy Watson conducted an unannounced subsequent complaint visit to deliver findings regarding the above allegations. LPA Watson met with the House Manager Gustavo Naranjo and the purpose of the visit was explained. LPA was granted entry to the facility.

The investigation consisted of the following:

On 06/06/2025 the department requested, obtained and reviewed the Personnel Report, Register of Facility /Clients, Board of Resolution, and Designation of Facility Responsibility. LPA Watson conducted interviews with Clients #1 - Clients #5 (C1-C5) and Staff #1 – Staff #9 (S1-S9). LPA Watson toured the facility with the administrator Gabriela Vasquez and found the facility clean and in good repair.

CONTINUED ON LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2025

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 11-AS-20250603151412

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: LACONIA HOME	FACILITY NUMBER: 198320387
	VISIT DATE: 09/11/2025

NARRATIVE

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The investigation revealed the following:

Allegation: Staff do not ensure resident oxygen tanks are operable.

On 06/06/2025 LPA Watson attempted to conduct interviews with Clients #1 - Clients #5 (C1-C5) but all Clients attempted to be interviewed, were non-verbal / non- ambulatory and unable to respond to the interview questions. On 06/06/2024 LPA Watson interviewed Staff #1- Staff #9 (S1-S9). LPA Watson asked the staff if they ensured that the facility had oxygen tanks that were operable. Out of those interviewed 9 out of 9 denied the above allegation. LPA Watson toured the facility and did not notice any oxygen tanks in an inoperable or faulty condition. Based on the information gathered, interviews conducted, and an analysis of records reviewed, LPA Watson found no evidence to support the allegation mentioned above. 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.

Allegation: Staff do not treat Clients with dignity or respect.

On 06/06/2025 LPA Watson attempted to conduct interviews with Clients #1 - Clients #5 (C1-C5) but all Clients attempted to be interviewed, were non-verbal / non- ambulatory and unable to respond to the interview questions. On 06/06/2024 LPA Watson interviewed Staff #1- Staff #9 (S1-S9). LPA Watson asked the staff ‘how the clients are treated at the facility? Out of those interviewed 9 out of 9 denied the above allegation. LPA Watson toured the facility and observed care givers speaking with and handling them with care. Based on the information gathered, interviews conducted, and an analysis of records reviewed, LPA Watson found no evidence to support the allegation mentioned above. 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.

CONTINUED ON LIC9099-C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2025

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20250603151412

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: LACONIA HOME	FACILITY NUMBER: 198320387
	VISIT DATE: 09/11/2025

NARRATIVE

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Allegations: Clients are not given privacy in their living space.

On 06/06/2025 LPA Watson attempted to conduct interviews with Clients #1 - Clients #5 (C1-C5) but all Clients attempted to be interviewed, were non-verbal / non- ambulatory and unable to respond to the interview questions. On 06/06/2024 LPA Watson interviewed Staff #1- Staff #9 (S1-S9). LPA Watson asked the staff, are clients given their privacy in their living space. Out of those interviewed 9 out of 9 denied the above allegation. LPA Watson toured the facility and observed that each resident at the facility needed one-to-one care and had a care giver feeding, bathing and monitoring each resident the entire time of the visit. Based on the information gathered, interviews conducted, and an analysis of records reviewed, LPA Watson found no evidence to support the allegation mentioned above. 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.

An exit interview was conducted with the House Manager Gustavo Naranjo and a copy of this report was given.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2025

LIC9099 (FAS) - (06/04)

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