198320410-7-17-2026-11-AS-SCIS-DWF2SG-20260728173907

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320410
Report Date: 07/17/2026
Date Signed: 07/17/2026 12:23:37 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, 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
03/09/2026 and conducted by Evaluator Troy Watson

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20260309083113

FACILITY NAME:	GELILA RESIDENTIAL CARE FACILITY		FACILITY NUMBER:	198320410
ADMINISTRATOR:	YOHANNES, CHRISTIAN		FACILITY TYPE:	740
ADDRESS:	3521 7TH AVE		TELEPHONE:	(310) 877-9395
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90018
CAPACITY:	6	CENSUS: 3	DATE:	07/17/2026
		UNANNOUNCED	TIME BEGAN:	08:38 AM
MET WITH:	ADERRA YOHANNES - LICENSEE		TIME COMPLETED:	12:22 PM

ALLEGATION(S):

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Facility staff is financially abusing resident.
Facility staff are not treating residents with dignity and respect.
Facility staff did not ensure resident was using medical device as prescribed.
Staff do not schedule structured activities for residents.

INVESTIGATION FINDINGS:

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**This report does not supersede the complaint investigation conducted on 03/17/2026 but is used to clarify findings**.

On 07/17/2026 at approximately 8:38 AM, Licensing Program Analyst (LPA) Troy Watson conducted a subsequent complaint visit. The department met with the Licensee, Ada Yohannes, and explained the purpose of the visit. The department was granted entry into the facility.

The investigation consisted of the following:
On 03/17/2026, the department requested, obtained, and reviewed copies of the following documents: Personnel Report dated 06/10/25, Resident Roster 2026, House Rules for R1, R4, and R5, Admission Agreements dated 03/29/25, 08/15/24, and 10/03/24, Personal Rights for R1, R4, and R5,

CONTINUED ON LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2026

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-20260309083113

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: GELILA RESIDENTIAL CARE FACILITY	FACILITY NUMBER: 198320410
	VISIT DATE: 07/17/2026

NARRATIVE

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Unusual Incident Reports for R1, R4, and R5, Telecommunication Device Notifications for R1, R4, and R5, Continued Monthly Resident Report for R3 dated 01/31/26, Care Facility LLC Invoices for R1, R4, and R5, Residential Care Facility Agreement (CA Provider Contract), Gmail correspondence regarding payment decrease dated 02/16/2026, Gmail correspondence requesting invoices dated 03/13/2026, InnovAge/PACE Supportive Housing Authorization and Client Payment dated 02/13/2026, and the facility Activity Schedule.
The department also conducted interviews with Staff #1–#3 (S1–S3) and Residents #1, #3, #4, #5 (R1–R5). An attempt to interview Resident #2 (R2) was made; however, R2 was unable to respond to the interview questions at the time of the visit. A separate interview with the spouse of R2 was documented as Witness #1 (W1).

On 07/16/2026 at approximately 02:30 PM, the department conducted additional interviews with Staff #1–#2 (S1–S2), Resident #2 (R2), and the power of attorney for Resident #3 (R3), documented as Witness #2 (W2). An attempt to interview Resident #1 was made; however, R1 was no longer at the facility at the time of visit.

Investigation revealed the following:

Allegation: Facility staff are financially abusing a resident

It is alleged that facility staff are financially abusing R1 by withholding or misrepresenting the receipt of their monthly rent grant funds.

On 03/17/2026 between 8:45 AM and 4:00 PM, the department interviewed the Administrator (A1). When asked about R1’s rental payments or rent related funds, A1 stated that no such incidents have occurred. A1 explained that the facility does not handle R1’s money or collect resident funds onsite, as rent payments are made directly by outside payors. A1 stated that a percentage of R1’s rental payments is paid by R1’s conservator and the balance of R1’s rental payments, as stated in contractual agreements, is paid by InnovAge/PACE via check, and R1’s conservator submits electronic payments directly to the Licensee via Zelle.

CONTINUED ON LIC9099-C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2026

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20260309083113

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: GELILA RESIDENTIAL CARE FACILITY	FACILITY NUMBER: 198320410
	VISIT DATE: 07/17/2026

NARRATIVE

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A1 was also asked directly to describe any situations where staff may have accessed, handled, or used R1’s money or personal belongings without permission. A1 responded no, stating that residents’ families pay their rent by either personal checks or by sending rent payments via Zelle, and that R1’s personal belongings were kept neatly in his private room.

On 03/17/2026, the department conducted interviews with Staff #1–#3 (S1–S3) and Residents #1, #3, #4, #5 (R1–R5). Out of those interviewed, 3 out of 3 staff, 4 out of 4 residents, and the spouse/conservator of R2, Witness #1 (W1), denied the above allegation.
On 07/16/2026 at approximately 02:30 PM, the department conducted additional interviews with Staff #1–#2 (S1–S2), Resident #2 (R2), and Witness #2 (W2). Out of those interviewed, 2 out of 2 staff denied the above allegation, and 1 resident and 1 power of attorney also denied the above allegation. An attempt to interview R1 was made, but R1 was no longer at the facility.

On 03/17/2026, the department reviewed Gmail correspondence indicating a decreased InnovAge payment dated 02/16/2026, showing a total of $2,234 due for January. A follow up email dated 03/13/2026 showed that InnovAge requested invoices to confirm the outstanding balance and indicated that remaining payments would be issued. The department requested and obtained documentation from the facility showing that the resident’s rental payment balance was paid in full by InnovAge on 04/17/2026 in the amount of $2,968.00.
The department also reviewed R1’s Authorization and Client Payment document, which showed R1’s gross income and the total co payment amount paid by InnovAge to the facility dated 02/13/2026. The department concluded that R1 has not been financially abused by the facility and that all monies for R1’s rental payments have been paid in full.

The department observed R1’s room neat, clean, and in good repair.
Based on interviews, record reviews, observations, and the information gathered, there is insufficient evidence to support the allegation that facility staff are financially abusing a resident. Although the allegation may have occurred or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed unsubstantiated.

CONTINUED ON LIC9099-C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2026

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20260309083113

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: GELILA RESIDENTIAL CARE FACILITY	FACILITY NUMBER: 198320410
	VISIT DATE: 07/17/2026

NARRATIVE

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Allegation: Facility staff are not treating residents with dignity and respect

It is alleged that facility staff are not treating R1 with dignity and respect, including turning off the television, restricting phone use, and refusing to provide the Wi Fi password.

On 03/17/2026 between 8:45 AM and 4:00 PM, the department interviewed A1. When asked whether staff ever spoke to or interacted with residents in a disrespectful manner or in a way that violated personal rights, A1 stated no. A1 was asked whether R1 had been disrespected by having his television turned off, having phone use restricted, or being denied the Wi Fi password. A1 stated that community TV is not permitted after 9:00 PM; however, R1 may watch TV in his bedroom at any time. A1 further stated that the Wi Fi password is available to all residents and that R1 has his own cell phone, which he may use freely.
On 03/17/2026, interviews were conducted with Staff #1–#3 (S1–S3) and Residents #1, #3, #4, #5 (R1–R5). Out of those interviewed, 3 out of 3 staff, 4 out of 4 residents, and Witness #1 (W1) denied the above allegation.

On 07/16/2026 at approximately 02:30 PM, the department conducted additional interviews with Staff #1–#2 (S1–S2), Resident #2, and Witness #2 (W2). Out of those interviewed, 2 out of 2 staff denied the above allegation, and 1 resident and 1 power of attorney also denied the above allegation. An attempt to interview R1 was made, but R1 was no longer at the facility.

On 03/17/2026, the department reviewed R1’s Telecommunications Device Notification dated 08/15/2024, which shows on page two, item 14, that R1 is allowed access to telephones to make and receive confidential calls. The department also reviewed the House Rules, which state that community TV use must be respectful, with no violent movies and appropriate volume control.
Based on interviews, record reviews, observations, and the information gathered, there is insufficient evidence to support the allegation that staff are not treating residents with dignity and respect. Although the allegation may have occurred or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed unsubstantiated.

CONTINUED ON LIC9099 - C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2026

LIC9099 (FAS) - (06/04)

Page: 4 of 6

Control Number 11-AS-20260309083113

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: GELILA RESIDENTIAL CARE FACILITY	FACILITY NUMBER: 198320410
	VISIT DATE: 07/17/2026

NARRATIVE

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Allegation: Facility staff did not ensure a resident was using a medical device as prescribed

It is alleged that facility staff did not ensure R1 used his prescribed medical devices as required.

On 03/17/2026 between 8:45 AM and 4:00 PM, the department interviewed A1. When asked what staff do to ensure residents use prescribed medical devices correctly and consistently as ordered by their physician, A1 stated that all staff are trained and assist R1 nightly by adding distilled water to his CPAP machine and inserting duodenal tubes into his nostrils at bedtime.
On 03/17/2026, the department conducted interviews with Staff #1–#3 (S1–S3) and Residents #1, #3, #4, #5 (R1–R5). Out of those interviewed, 3 out of 3 staff, 4 out of 4 residents, and Witness #1 (W1) denied the above allegation.
On 07/16/2026 at approximately 02:30 PM, the department conducted additional interviews with Staff #1–#2 (S1–S2), Resident #2, and Witness #2 (W2). Out of those interviewed, 2 out of 2 staff denied the above allegation, and 1 resident and 1 power of attorney also denied the allegation. An attempt to interview R1 was made, but R1 was no longer at the facility.
The department toured the facility with the Licensee and observed R1’s CPAP machine in his bedroom. The machine appeared clean, operational, and in good repair, with a clean bottle of distilled water placed next to it.
Based on interviews, record reviews, observations, and the information gathered, there is insufficient evidence to support the allegation that staff did not ensure R1 used his prescribed medical device as required. Although the allegation may have occurred or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed unsubstantiated.
Allegation: Staff do not schedule structured activities for residents
It is alleged that facility staff do not allow residents to venture away from the facility to enjoy outdoor activities or provide scheduled structured activities for residents.
The facility provides an activity area with games and a television, outdoor walking areas, a backyard, and community outings for residents, including residents who use wheelchairs.
On 03/17/2026, the department conducted interviews with Staff #1–#3 (S1–S3) and Residents #1, #3, #4, #5 (R1–R5). Out of those interviewed, 3 out of 3 staff, 4 out of 4 residents, and Witness #1 (W1) denied the above allegation.

CONTINUED ON LIC9099 - C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2026

LIC9099 (FAS) - (06/04)

Page: 5 of 6

Control Number 11-AS-20260309083113

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: GELILA RESIDENTIAL CARE FACILITY	FACILITY NUMBER: 198320410
	VISIT DATE: 07/17/2026

NARRATIVE

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On 07/16/2026 at approximately 02:30 PM, the department conducted additional interviews with Staff #1–#2 (S1–S2), Resident #2, and Witness #2 (W2). Out of those interviewed, 2 out of 2 staff denied the above allegation, and 1 resident and 1 power of attorney also denied the allegation. An attempt to interview R1 was made, but R1 was no longer at the facility.
The department interviewed R1 regarding the types of activities the facility offered and what he participated in. R1 stated that they attended InnovAge/PACE Day Care, watched television, and went to restaurants and parks with their daughter. The department reviewed the activity calendar provided by InnovAge/PACE, which showed various activities for the residents such as board games, tennis, painting, field trips, aerobics, basketball, and arts and crafts.
Based on interviews, record reviews, observations, and the information gathered, there is insufficient evidence to support the allegation that staff do not schedule structured activities for residents. Although the allegation may have occurred or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed unsubstantiated.

No deficiencies were cited, and no citation was issued.

An exit interview was conducted with the Licensee, Aderra Yohannes, and a copy of this report was provided.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:	DATE: 07/17/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2026

LIC9099 (FAS) - (06/04)

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