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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320504
Report Date: 05/01/2025
Date Signed: 05/01/2025 04:12:23 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
04/27/2025 and conducted by Evaluator Regina Cloyd
COMPLAINT CONTROL NUMBER: 11-AS-20250427215900
FACILITY NAME:CHEZ BON GUEST HOMEFACILITY NUMBER:
198320504
ADMINISTRATOR:IBRAHIM ZAYATFACILITY TYPE:
735
ADDRESS:1206 WALNUT AVETELEPHONE:
(562) 591-1411
CITY:LONG BEACHSTATE: CAZIP CODE:
90813
CAPACITY:82CENSUS: 82DATE:
05/01/2025
UNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Ibrahim Zayat/AdministratorTIME COMPLETED:
04:30 PM
ALLEGATION(S):
1
2
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9
Staff do not prevent inappropriate physical interactions between clients.
INVESTIGATION FINDINGS:
1
2
3
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5
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9
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12
13
On 05/01/25, Licensing Program Analyst (LPA) Regina Cloyd conducted an initial visit to gather information regarding the above allegation. LPA met with Administrator Ibrahim Zayat and the purpose of the visit was explained. LPA was granted entry to the facility.

Investigation consisted of the following: On 05/01/25, LPA reviewed Register of Facility Client Roster, Personnel Report (dated 02/25), Rules and Regulations for Residents and Visitors, and Admission Agreement (Revised 01/2025). LPA interviewed Administrator, Assistant Administrator, Direct Staff, Food Services, Food Services/Housekeeping, Maintenance and eight clients (#1 – 8).

Investigation revealed the following:

Continue to LIC9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2025
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-20250427215900
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: CHEZ BON GUEST HOME
FACILITY NUMBER: 198320504
VISIT DATE: 05/01/2025
NARRATIVE
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Allegation: Staff do not prevent inappropriate physical interactions between clients.

Regarding the allegation "Staff do not prevent inappropriate physical interactions between clients,” it is being alleged that Client #2 (C2) physically and verbally abuses Client #1 (C1). Six out of six staff (#1 – 6) interviews denied the allegation. Staff #3 (S3) indicated that S3 spoke with C1 and C1 denied the allegation. Eight out of eight client (#1 – 8), including C1 and C2, indicated staff will intervene when there are client altercations. Interview with C1 and C2 denied the allegation. Six out of six clients (C1, C3-C6, C8) indicated that they feel safe at the facility.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

No deficiencies issued.

An exit interview was conducted with Direct Staff David Flores. Due to technical issues, a printed copy of this report was not provided during the exit but an email copy will be provided to the Administrator Ibrahim Zayat.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2