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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198600410
Report Date: 12/22/2025
Date Signed: 12/22/2025 01:17:53 PM

Document Has Been Signed on 12/22/2025 01:17 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME:CASA BONITAFACILITY NUMBER:
198600410
ADMINISTRATOR/
DIRECTOR:		CLAUDIA LUJANFACILITY TYPE:
735
ADDRESS:13945 CLOSE STREETTELEPHONE:
5629412890
CITY:WHITTIERSTATE: CAZIP CODE:
90605
CAPACITY: 6CENSUS: 6DATE:
12/22/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:16 AM
MET WITH:Administrator Claudia LujanTIME VISIT/
INSPECTION COMPLETED:
02:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Case Management Visit-Incident on 12/22/2025. LPA was greeted by Direct Support Professional II (DSP) - Maria Hernandez and explained the purpose of the visit. Administrator Claudia Lujan and alternate administrator Dania De La Riva arrived shortly after.

Case Management findings:

On 10/30/2025, LPA Ramirez received a Vendor Special Incident Report (ELARC-QA#268) from Eastern Los Angeles Regional Center that revealed on 10/29/2025 at approximately 7pm, C1 was bringing their wet clothing to a hamper, which already contained dry clothing. Staff#1 (S1) attempted to take the hamper from C1 to inform C1 to not mix their wet clothes and dry clothes. C1 then reached for their shoes to place them in the hamper, and S1 pulled the shoes away from C1. C1 became upset and made a fist and punched S1 on the right side of S1’s face. S1 responded by slapping C1 with an open hand on C1’s cheek. Staff#2-3 (S2 – S3) immediately intervened and separated C1 and S1. C1 was given immediate assistance, and first aid was provided. C1 denied being injured and declined medical attention. S1 was immediately taken off the schedule and placed on leave pending an investigation. On 10/30/2025, Norwalk Sheriffs (Report# NWK25303-0134) was notified, ELARC Service Coordinator- Dora Contreras was notified, Community Care Licensing- Adult & Senior Care Licensing Program Analyst (LPA) Bennette Pena was notified, and Adult Protective Services (APS) was notified. As a result of an internal investigation by the facility, S1’s employment was terminated on 11/05/2025.



See 809-C
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Kimberly Ramirez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/22/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: CASA BONITA
FACILITY NUMBER: 198600410
VISIT DATE: 12/22/2025
NARRATIVE
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On 12/22/2025, LPA Ramirez conducted two (2) staff interviews. These interviews corroborated that on 10/29/2025 at approximately 7pm, S1 slapped C1 with an open hand after C1 punched S1 on the right side of their face. During the interview process with C1, C1 was unable to provide reliable responses to time and place. Given this lack of orientation, I concluded C1’s responses to be unreliable. During record review, LPA Ramirez observed Eastern Los Angeles Letter of Findings and Recommendations Investigation dated 11/24/2025. This report reveled that after speaking with Administrator De La Riva and review of documents, the allegation of physical abuse by staff S1 against C1 was Substantiated.

Based on interviews conducted and documents reviewed, S1’s conduct on 10/29/2025 posed an immediate risk to the health, safety, or personal rights of persons in care. One (1) type A deficiency is being cited for personal rights violation. An exit interview was conducted with Administrator Lujan. A copy of this report, 809-D and appeals rights were provided.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Kimberly Ramirez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/22/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/22/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 12/22/2025 01:17 PM - It Cannot Be Edited


Created By: Kimberly Ramirez On 12/22/2025 at 12:55 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: CASA BONITA
FACILITY NUMBER: 198600410

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/22/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/23/2025
Section Cited
HSC
80072(a)(3)

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(a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule,
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Administrator Lujan agreed to provide a plan on when staff re-training will be conducted on 80072(a)(3) and on C1's behavior plan. Plan must be received by 12/23/2025. Staff re-trainings must be received by 01/09/2026.
Email: Kimberly.Ramirez@dss.ca.gov
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coercion, threat, mental abuse, or other actions of a punitive nature, including but not limited to: aids to physical functioning. This requirement was not met as evidenced by: S1 slapped C1 with an open hand across their face.
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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.
Fernando Fierros
NAME OF LICENSING PROGRAM MANAGER:
Kimberly Ramirez
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 12/22/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/22/2025


LIC809 (FAS) - (06/04)
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