198320498-8-20-2026-11-AS-PMAA-DXCU6B-20260827151803

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320498
Report Date: 08/20/2026
Date Signed: 08/20/2026 01:47:54 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
11/25/2025 and conducted by Evaluator Jose Anguiano

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20251125153143

FACILITY NAME:	GENERATIONS OF LOS ANGELES ASSISTED LVNG. FACILITY		FACILITY NUMBER:	198320498
ADMINISTRATOR:	CAMARIN JOHNSON		FACILITY TYPE:	740
ADDRESS:	3540 MARTIN LUTHER KING, JR.		TELEPHONE:	(310) 638-4113
CITY:	LYNWOOD	STATE: CA	ZIP CODE:	90262
CAPACITY:	178	CENSUS: 114	DATE:	08/20/2026
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Kathleen Tamondong		TIME COMPLETED:	01:54 PM

ALLEGATION(S):

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Staff left resident soiled for an extended period
Staff handled resident in a rough manner
Staff did not ensure resident received physical therapy

INVESTIGATION FINDINGS:

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On 08/20/2026 at approximately 9:00AM Licensing Program Analyst (LPA) Jose Anguiano conducted an unannounced subsequent visit to deliver findings. LPA met with Administrator Kathleen Tamondong and the purpose of the visit was explained.
Investigation consisted of the following:
On 12/04/2025 at approximately 9:00 AM, the Department conducted interviews with eight (8) staff members (S1–S8) and nine (9) residents (R1–R9). The Department also reviewed staff and resident rosters, the caregiver staff schedule, R1’s routine check logs, the December staff assignment log, staff in-service and orientation training records, and the facility’s admission agreement. On 08/17/2026 at 12:00Pm, The Department reviewed R1's Routine Check documentation dated 11/24/2025 through 11/25/2025; Application for Assessment/Evaluation and 72-Hour Detention dated 11/24/2025; Southern California Hospital at Culver City Wound Care Initial Assessment and Physician History and Physical-
Please see report continuation on (LIC9099-C).

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Anguiano
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026

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 3

Control Number 11-AS-20251125153143

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: GENERATIONS OF LOS ANGELES ASSISTED LVNG. FACILITY	FACILITY NUMBER: 198320498
	VISIT DATE: 08/20/2026

NARRATIVE

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dated 11/27/2025; and R1's Individual Service Plan by Concise Care Group. On 01/09/2026 at 9:00AM, The Department conducted additional interviews with five (5) residents (R10–R14)[JA1.1].
The investigation revealed the following: Regarding the allegation “Staff left resident soiled for an extended period” It is being alleged that staff left the resident sitting in urine for an extended period before providing assistance. The Department was unable to observe R1 because R1 was not present at the facility during the visits. During the visit, the department did not observe any other residents being treated in the manner alleged. Interviews conducted revealed the following: The Department interviewed eleven (11) residents (R1-R11). The Department found 1 of 11 residents (R1), agreed with the allegation 10 of 11 residents (R2-R11) disagreed with the allegation and 3 additional residents (R12-R14) were unable or unwilling to corroborate information. Interview with R1 revealed inconsistent information; R1 appeared confused, had difficulty staying on topic, and incorrectly identified current location. Interviews with eight (8) staff members (S1–S8) disagreed with the allegation. Records reviewed revealed the following: Routine Check Log for (R1) dated 11/15/2025 to 11/26/2025 indicated staff documented multiple diaper checks and changes, as well as several occasions when R1 refused diaper changes or asked staff to leave. A 72-hour Detention for Evaluation and Treatment document dated 11/24/2025 at 5:20PM, also indicated that (R1) was refusing care from staff. The Facility Resident Appraisal documented R1’s mental condition as having slight confusion.
Based on interviews and records reviewed, although the allegations 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.
Regarding the allegation “Staff handled resident in a rough manner. It is being alleged that staff handled the resident in a rough and inappropriate manner while providing assistance. The Department did not observe conditions or staff interactions with residents that corroborated the allegation. Interviews conducted revealed the following: The Department interviewed eleven (11) residents (R1-R11). The Department found 1 of 11 residents (R1), agreed with the allegation 10 of 11 residents (R2-R11) disagreed with the allegation and 3 additional residents (R12-R14) were unable or unwilling to corroborate information. Interviews with eight (8) staff members (S1–S8) disagreed with the allegation. Records reviewed revealed the following: Southern California Hospital record dated 11/27/2025 did not contain medical documentation corroborating an injury resulting from staff handling R1 in the manner alleged.

Please see report continuation (LIC9099-C)

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Anguiano
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20251125153143

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: GENERATIONS OF LOS ANGELES ASSISTED LVNG. FACILITY	FACILITY NUMBER: 198320498
	VISIT DATE: 08/20/2026

NARRATIVE

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Based on interviews and records reviewed, although the allegations 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 allegations are UNSUBSTANTIATED.
“Staff did not ensure resident received physical therapy” It is being alleged that staff failed to ensure R1 received prescribed physical therapy services. The Department did not observe conditions or staff interactions that corroborated the allegation. Interviews conducted revealed the following: The Department interviewed eleven (11) residents (R1-R11). The Department found 1 of 11 residents (R1), agreed with the allegation 10 of 11 residents (R2-R11) disagreed with the allegation and 3 additional residents (R12-R14) were unable or unwilling to corroborate information. Interviews with eight (8) staff members (S1–S8) disagreed with the allegation. Records reviewed revealed the following: Individual Service Plan by Concise Care Group dated 06/10/2025 did not indicate that Physical Therapy (PT) was prescribed, required, or supported by an active physician order or referral prior to R1’s admission to the facility. Southern California Hospital – Physical Therapy Initial Evaluation, dated 11/29/2025, indicates (PT) was ordered and treatment was initiated during R1’s hospitalization. The record does not indicate that Generations had previously received an active PT order or failed to arrange therapy. Additional information from Hospital record dated 12/04/2025, states R1 received a trial of (PT) but made no measurable progress and was discharged from further skilled PT, with a Hoyer lift and custodial assistance recommended.
Based on interviews and records reviewed, although the allegations 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 allegations are UNSUBSTANTIATED.

No deficiencies were cited regarding the above allegations, and an exit interview was conducted with the Administrator.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Anguiano
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2026

LIC9099 (FAS) - (06/04)

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