198320460-7-31-2025-11-AS-EMAZ-DLMS4F-20250918133241

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320460
Report Date: 07/31/2025
Date Signed: 07/31/2025 04:30:24 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
07/17/2025 and conducted by Evaluator Deborah Lee

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20250717164329

FACILITY NAME:	MOUNTAIN TOP - E. SILVA		FACILITY NUMBER:	198320460
ADMINISTRATOR:	COREY SPIGHT		FACILITY TYPE:	737
ADDRESS:	1910 E. SILVA STREET		TELEPHONE:	(760) 218-4293
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90807
CAPACITY:	4	CENSUS: 4	DATE:	07/31/2025
		UNANNOUNCED	TIME BEGAN:	08:16 AM
MET WITH:	Dolores Cespedes		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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Facility staff did not meet the resident's dietary needs.
Staff did not provided resident with activities.
Staff did not provide resident with nutritious meals.

INVESTIGATION FINDINGS:

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On July 31, 2025 The Department of Social Services staff conducted a subsequent complaint visit to continue investigation and to deliver findings. The Department met with Administrators Dolores Cespedes and Daniel Herrera, and the purpose of the visit was explained.

Investigation consisted of the following:
On July 24, 2025, the Department conducted an initial 10-day visit to gather information regarding the above allegations. On July 24, 2025, the Department obtained the following documents for review: Staff roster (dated 7/13/25), Resident roster (dated 6/6/25), C1's Admission Agreement (6/6/25), C1"s 7 day facility report (dated 6/12/25), C1's Physician's Report (dated 8/2/24),Facility Menu (dated February-October 2025),C1's Activity Calendar (dated July 2025), C1's Activity Assessment (dated 6/6/25).

On 7/31/25, the department obtained and reviewed the following documents: C1's Weight Record (dated 6/7-7/29), C1's 30-day facility report (dated 7/3/25), and C1's monthly Individual Behavior Support Plan (IBSP).

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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2025

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-20250717164329

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: MOUNTAIN TOP - E. SILVA	FACILITY NUMBER: 198320460
	VISIT DATE: 07/31/2025

NARRATIVE

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On 7/31/25, the Department conducted 1 Administrator interview and RBT Lead interview (A1-A2); 5 staff interviews (S1-S5), 3 (attempted) client interviews (C1-C3), 1 facility dietitian (W2) interview. The Department spoke with placement agency (W1) via telephone.

Investigation revealed the following:

Allegation: Facility staff did not meet the resident's dietary needs.

The detail of the complaint alleges that because the staff are not meeting dietary needs, C1 has gained 15 pounds since C1 has moved into facility on 6/6/2025. On 7/31/2025, between 9:00am and 10:30am, the Department interviewed Administrator (A1) and RBT Lead (A2) who denied the allegation and stated C1 has gained some weight but not 15lbs, and weight gain is not due to them failing to meet C1’s dietary needs. The Department reviewed C1’s weight record which corroborates that C1 has not gained 15lbs as reported and has in fact lost weight. C1's chart records weight as follows: 6/7/25-- 197.4, 6/30/25-- 198.2, 7/10/25--206 and 7/29--199.8. On 7/31/25 between 10:30am and 11:30am, the Department interviewed 5 staff (S1-S5) regarding the allegation, and of those interviewed, 5 out of 5 denied the allegation stating that the facility meets all clients dietary needs including C1's. Additionally 5 out of 5 identified restrictions from C1's family and they adhere to those restrictions. On 7/31/25, the Department attempted to interview 3 clients and of those attempts (1 out of 3 ) stated that the facility serves nutritious food that he likes. 2 out of 3 declined the interview as they were engage in other activities at time of visit. Lastly, the Department interviewed the facility Dietitian (W2) who provides menu planning and training on healthy eating.

Based on the interviews conducted and the documents reviewed, there is insufficient evidence to support allegation.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2025

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20250717164329

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: MOUNTAIN TOP - E. SILVA	FACILITY NUMBER: 198320460
	VISIT DATE: 07/31/2025

NARRATIVE

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Allegation: Staff did not provided resident with activities.

The detail of the complaint alleges the facility doesn't have activities for C1 to participate in. On 7/31/25, between 9:00am and 10:30am the Department interviewed Administrator (A1) and RBT Lead (A2) who denied allegation stating that not only does C1 participates in the facility scheduled activities, but participates in Day Program activities M-F as a day program staff come out to the facility to provide various activities such a walks, going to the park and most recently a visit to the zoo. On 7/31/25, The department interviewed 5 staff regarding the allegation and 5 out of 5 denied the allegation stating that staff does provide a variety of activities for C1 and the rest of the clients to participate in. However according to the 5 staff interviewed, it is always the client's choice if they choose to participate or not. On 7/31/25, during the time of visit, the Department observed various activities clients were participating in. Lastly, the department reviewed C1's personal activity schedule which has a variety of activities offered to C1.

Based on the interviews, observation and review of documents, there is insufficient evidence to support above allegation.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2025

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20250717164329

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: MOUNTAIN TOP - E. SILVA	FACILITY NUMBER: 198320460
	VISIT DATE: 07/31/2025

NARRATIVE

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Allegation: Staff did not provide resident with nutritious meals.

The detail of the complaint alleges the staff does not provide nutritious meals. On 7/31/25 9:00am and 10:30am the Department interviewed the Administrator (A1) and RBT Lead (A2), who denied allegation, stating that the facility does service nutritious meals and they have a facility Dietitian (W2) who visits the facility twice a month and provides menu implementation and training for the staff on healthy meal prep and shopping to support healthy eating habits. On 7/31/25, the Department interviewed 5 staff regarding the allegation and 5 out of 5 staff interviewed denied allegation, stating that nutritious meals are always served to the clients in care. Additionally, 5 out of the 5 interviewed stated that they adhere to the menu provided and follow any recommendations by the facility Dietician. The Department attempted 3 client interviews 1 out of 3 stated that the facility provides nutritious meals. 2 of 3 clients did not interview due to engaging in other activities at time of visit--They declined. On 7/31/25, the Department reviewed the facility menu which reveals the facility offers well balanced meals. On 7/31/25 at 2:45pm, the Department interview the facility Dietician who stated that she comes out twice per month to provide guidance on menu planning, implementation and training on healthy eating habits. On 7/31/25 during tour of facility the Department observed that the facility has an ample supply of healthy/nutritious food on hand.

Based on interviews, observation, and review of records there is insufficient evidence to support above allegation.

Although the allegations above may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2025

LIC9099 (FAS) - (06/04)

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