198600539-9-11-2025-28-AS-DSIS-DMNP9E-20251021110657

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 09/11/2025
Date Signed: 09/11/2025 01:40:27 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
09/08/2025 and conducted by Evaluator Erik Zaragoza

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250908111312

FACILITY NAME:	PICO RIVERA GARDENS		FACILITY NUMBER:	198600539
ADMINISTRATOR:	JOYCE GARCIA		FACILITY TYPE:	735
ADDRESS:	6525 ROSEMEAD BLVD.		TELEPHONE:	(562) 949-8489
CITY:	PICO RIVERA	STATE: CA	ZIP CODE:	90660
CAPACITY:	185	CENSUS: 169	DATE:	09/11/2025
		UNANNOUNCED	TIME BEGAN:	09:32 AM
MET WITH:	Joyce Garcia - Administrator		TIME COMPLETED:	01:55 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff did not prevent a resident from physically assaulting another resident in care
Staff did not ensure that resident's beverage was free of contamination

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Erik Zaragoza conducted an initial unannounced complaint visit to address the allegations listed above. LPA met with Joyce Garcia, administrator for the facility, and explained the purpose of the visit.

The investigation consisted of the following: During the visit LPA toured the kitchen of the facility during lunch preparation, obtained the staff and client rosters, reviewed surveillance camera footage of an incident that occurred on 9/8/2025, and interviewed Staff #1 - 4 (S1 - S4), along with Clients #1 - 12 (C1 - C12).

The investigation revealed the following: In regards to the allegation that "Staff did not prevent a resident from physically assaulting another resident in care," it is alleged that C6 punched C5 in the head, and that the facility did not call law enforcement following the incident.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Erik Zaragoza
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2025

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 28-AS-20250908111312

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: 09/11/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

During interviews with the clients, none of them corroborated the allegation. During an interview with C5, they stated that staff did respond to the incident appropriately and called law enforcement afterwards. Another client stated that they did witness the incident, however staff did assist C5 afterwards and that the paramedics were called. During interviews with the staff, none of them corroborated the allegation. One staff interviewed stated that C6 did punch C5 in the dining room, however they responded immediately and called 911 to report the assault. Another staff interviewed stated that paramedics arrived and took C5 to the hospital to be evaluated. During video surveillance review of the incident, LPA observed that C6 threw a single punch that knocked C5 to the ground, and that kitchen staff immediately reported the incident to the administrator. LPA also observed that sheriffs were called to the facility to speak with the parties that were involved in the incident.

In regards to the allegation that "Staff did not ensure that resident's beverage was free of contamination," it is alleged that a C1's coffee was contaminated with pubic hair and germs. During interviews with the clients, eleven (11) out of twelve (12) interviewed did not corroborate the allegation. One client interviewed stated that there is nothing wrong with the beverages served at the facility. Another client interviewed stated that they have not observed their beverages contaminated with any foreign substances in the past. During interviews with the staff, none of them corroborated the allegation. All staff interviewed stated that they are not contaminating the beverages of any of the clients in the facility. During a tour of the kitchen, all food preparation areas were observed to be in clean and sanitary condition. LPA observed the coffee machine that is used to make coffee for the clients was also in sanitary condition.

Based on statements and interviews conducted with staff, clients, review of client files and facility file records, there was not enough supportive evidence to concur with the reported allegations. 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.

Exit interview held, and a copy of this report will be emailed to the administrator.

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Erik Zaragoza
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 2