198600173-4-21-2026-31-AS-NMAN-DUFLCL-20260526083831

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600173
Report Date: 04/21/2026
Date Signed: 04/21/2026 06:24:45 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/18/2025 and conducted by Evaluator Antonia Alvizar-Ettima

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20250918153501

FACILITY NAME:	J-J ADULT CARE HOME		FACILITY NUMBER:	198600173
ADMINISTRATOR:	CATHERINE ABALOS		FACILITY TYPE:	735
ADDRESS:	1233 BOYNTON STREET		TELEPHONE:	(818) 243-0628
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY:	6	CENSUS: 5	DATE:	04/21/2026
		UNANNOUNCED	TIME BEGAN:	06:00 PM
MET WITH:	Administrator,Catherine Abalos & Lead Direct Support Prefessional (DSP), Gertrudes Armanento		TIME COMPLETED:	06:35 PM

ALLEGATION(S):

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Staff is verbally abusing resident in care
Staff threatens resident in care

INVESTIGATION FINDINGS:

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At 3:15p.m., Licensing Program Analyst (LPA) Antonia Alvizar- Ettima conducted an unannounced subsequent visit to deliver the finding for the above noted allegations. LPA was greeted by the Lead Direct Support Professional (DSP), and the purpose of the visit was explained. The Administrator later joined the visit.
During this visit at 3:25p.m., LPA and Lead DSP conducted a physical plan tour and did not observe any immediate health and safety issues.

During initial visit on 09/19/25 at 10:45a.m, LPA requested and obtained copies of the facility’s client and staff rosters. At approximately 11:05a.m., LPA and staff (S1) conducted a physical plant walk-through. Between 11:25a.m. – 2:15p.m., LPA conducted interviews with the Administrator, two (2) staff and two (2) out of five (5) five clients including client #1 (C1). Three (3) clients were not interviewed due to

Cont. on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:	DATE: 04/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2026

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 31-AS-20250918153501

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: J-J ADULT CARE HOME	FACILITY NUMBER: 198600173
	VISIT DATE: 04/21/2026

NARRATIVE

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Cont. from LIC 9099

medical condition therefore, LPA terminated the interviews. At about 3:05p.m. LPA received C1’s Identification & Emergency Information, Appraisal/Needs, Daily Notes, Staff In-Service, staff contact information and other pertinent documentation.

Prior to this visit on 04/18/26, LPA reviewed the information, and the documentation previously obtained from the facility.

Staff is verbally abusing resident in care

It was alleged that Staff #1 (S1) made offensive and inappropriate comments to Client #1 (C1) regarding C1’s nationality. C1 reported that S1 stated, “So you are Mexican? Trump is after you,” and laughed. C1 stated they felt hurt and did not laugh in response. Administrator denied the allegation and reported that staff are trained to always maintain professional and respectful communication with clients. Administrator indicated that no prior complaints or incidents involving verbal abuse by S1 have been reported or documented. Administrator further stated that staff receive ongoing training related to client rights, dignity, and appropriate interactions. Staff interviews conducted revealed that staff have not observed S1 or other staff engaging in verbal abuse toward C1 or other clients in care. Staff reported that interactions with clients are conducted in a respectful and professional manner. Staff further indicated that any concerns or complaints by clients are reported to management and addressed promptly. Additional client interview conducted did not support the allegation and reported no concerns regarding staff behavior. Client indicated that staff treat them with respect and have not witnessed or experiencing verbal abuse. LPA did not observe any staff engaging in verbally abusive behavior during the course of the investigation. Records reviewed did not reveal documentation of prior incidents or concerns related to verbal abuse by staff.

Based on interviews, observations, and records reviewed, there is insufficient evidence to support the allegation. Therefore the allegation is UNSUBSTANTIATED at this time.

Staff threatens resident in care

It was alleged that Staff #2 (S2) made verbal threats toward Client #1 (C1), including engaging in intimidating behavior by standing in close proximity, described as “chest to chest,” and that C1 was pushed

Cont. on LIC 9099-C

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:	DATE: 04/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20250918153501

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: J-J ADULT CARE HOME	FACILITY NUMBER: 198600173
	VISIT DATE: 04/21/2026

NARRATIVE

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Cont. from LIC 9099-C

back slightly. C1 reported the interaction; however, additional client interview did not report concerns related to staff threatening behavior. They have not witnessed staff threaten or intimidate clients and reported feeling safe in the facility. Administrator denied the allegation and reported that staff are trained to manage resident interactions in a calm and respectful manner. Administrator indicated that no prior incidents or complaints involving S2 engaging in threatening behavior have been reported or documented. Administrator further stated that staff are trained in de-escalation techniques and appropriate communication. Staff interviews revealed that staff do not engage in threatening behavior toward clients and reported that interactions are conducted respectfully. Staff indicated that they have not observed S2 or other staff threaten C1 or other clients in care. LPA did not observe any threatening interactions between staff and clients during the course of the visit. Records reviewed did not indicate documentation of staff threatening clients, including S2.

Based on interviews, observations, and records reviewed, there is insufficient evidence to support the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima
LICENSING EVALUATOR SIGNATURE:	DATE: 04/21/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2026

LIC9099 (FAS) - (06/04)

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