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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600085
Report Date: 08/27/2025
Date Signed: 08/27/2025 04:07:18 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/19/2025 and conducted by Evaluator Blanca Gonzalez
COMPLAINT CONTROL NUMBER: 28-AS-20250819112014
FACILITY NAME:CHOICES R US - WOODHUEFACILITY NUMBER:
198600085
ADMINISTRATOR:LY, LANFACILITY TYPE:
735
ADDRESS:9523 WOODHUE STTELEPHONE:
(562) 942-1419
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY:6CENSUS: 4DATE:
08/27/2025
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Lan Ly, AdministratorTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff mismanaged resident's medications
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Blanca Gonzalez conducted an unannounced initial10-day complaint visit regarding the allegation listed above. LPA met with Mya Hames and Lisa Mosely, Caregivers, and explained the reason for the visit. Administrator Lan Ly arrived shortly after.

The investigation consisted of the following: LPA obtained staff and client rosters, conducted record review including medication administration records (MAR) and interviews with staff #1-3(S1-S3). Also reviewed was a corrective action plan (CAP) from the East Los Angeles Regional Center (ELARC) dated 08/18/25.

continued on LIC 9099C
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Blanca Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2025
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 3
Control Number 28-AS-20250819112014
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: CHOICES R US - WOODHUE
FACILITY NUMBER: 198600085
VISIT DATE: 08/27/2025
NARRATIVE
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continued from 9099

The investigation revealed the following: In regard to the allegation “Staff mismanaged resident's medications,” it is alleged that on 08/11/2025, C1 was not given 1 of 2 Omega-3 tablets.

During interviews with staff, staff corroborated the allegation. S1 stated they were not there when then incident occurred but were aware of what happened and received training after the fact. S2 stated they were there with regional center staff reviewing the MARs and medication and noticed the bubble pack had not been popped for the afternoon Omega-3 for the previous day. S3 stated was not there when the incident happened but was made aware and prepared an in-service training.

During review of MARs, it was not noted that C1 was not given 1 of 2 Omega-3 tablets for 8/11/2025, although bubble pack had not been popped. ELARC's CAP also indicated that medications for C1 were missed that afternoon.

Based on LPA’s record review and interviews conducted with the staff, the preponderance of evidence standard has been met for the above allegation, therefore the allegation is found to be SUBSTANTIATED. California Code of Regulations Title 22, Division 6, is being cited on the attached LIC9099D pages.

Exit interview was held and a copy of this report along with the appeal rights were provided to Administrator Lan Ly.

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Blanca Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20250819112014
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: CHOICES R US - WOODHUE
FACILITY NUMBER: 198600085
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/27/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/28/2025
Section Cited
CCR
80075(b)
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80075 Health Related Services
(b) Clients shall be assisted as needed with self-administration of prescription and nonprescription medications.
This regulation was not met as evidenced by:
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Adminstrator has scheduled an in-service staff training to discuss medication check policy and will submit, via email, the sign in sheet for staff in attendence by POC due date
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Based on record review and interviews, LPA determined that C1 was not given 1 of 2 prescribed Omega-3 medication which poses an immediate health and safety risk to clients under care and supervision.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Blanca Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/27/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3