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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 07/01/2024
Date Signed: 07/01/2024 03:57:06 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
06/24/2024 and conducted by Evaluator Alberto Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240624094415
FACILITY NAME:PICO RIVERA GARDENSFACILITY NUMBER:
198600539
ADMINISTRATOR:SANTOS DOMINGUEZFACILITY TYPE:
735
ADDRESS:6525 ROSEMEAD BLVD.TELEPHONE:
(562) 949-8489
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY:185CENSUS: 136DATE:
07/01/2024
UNANNOUNCEDTIME BEGAN:
09:59 AM
MET WITH:Tony Olmos - AdministratorTIME COMPLETED:
04:07 PM
ALLEGATION(S):
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Staff does not treat resident with respect
Staff kicks resident
Residents are smoking marijuana in the facility
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alberto Lopez conducted an unannounced initial complaint visit regarding the above allegations. LPA met with Tony Olmos (Administrator) and explained the reason for the visit.

The investigation consisted of LPA interviewing five (5) staff, fourteen (14) Clients and taking a tour of both floors of facility. LPA reviewed and obtained copy of staff and resident roster.

The investigation revealed the following:

Allegation: Staff does not treat resident with respect. It is alleged that staff are disrespectful towards clients.
LPA interviewed five (5) staff and five (5) of (5) staff denied the allegation. LPA interviewed fourteen (14) clients and eleven (11) of fourteen (14) clients could not collaborate the allegation. LPA did not observe staff being disrespectful to any clients during the entire visit. There is insufficient evidence to substantiate this allegation. (CONTINUED ON 9099C)
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Alberto Lopez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2024
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 28-AS-20240624094415
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: PICO RIVERA GARDENS
FACILITY NUMBER: 198600539
VISIT DATE: 07/01/2024
NARRATIVE
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Allegation: Staff kicks resident. It is alleged that staff kicked C1 in attempt to wake C1.

LPA interviewed five (5) staff and five (5) of five (5) staff denied the allegation. LPA interviewed fourteen (14) clients and fourteen (14) of fourteen (14) clients were not able to collaborate the allegation. C1 stated C1 was told by another client that is what occurred but did not witness or feel a kick. There is insufficient evidence to substantiate this allegation.

Allegation: Residents are smoking marijuana in the facility. It is alleged that some clients are smoking marijuana, drinking alcohol, and playing loud music at 1:00am at the facility.

LPA interviewed five (5) staff, and five (5) of five (5) staff denied the allegation. Administrative staff stated they had not revived any such complaints. LPA interviewed fourteen clients and nine (9) of fourteen (14) clients were not able to collaborate the allegations. During the entire visit, LPA did not observe any clients smoking marijuana, drinking alcohol, or playing loud music anywhere in the facility. There is insufficient evidence to substantiate this allegation.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Based on LPA’s interviews, and observations during this investigation, no deficiencies are being cited today. Exit interview conducted and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Alberto Lopez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2