198600604-4-23-2026-28-AS-DSIS-DTSU9T-20260505152338

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600604
Report Date: 04/23/2026
Date Signed: 04/23/2026 07:09:38 PM

Unsubstantiated

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
04/08/2026 and conducted by Evaluator Gabriela Castro

COMPLAINT CONTROL NUMBER: 28-AS-20260408091450

FACILITY NAME:	MERCY RESIDENTIAL HOME		FACILITY NUMBER:	198600604
ADMINISTRATOR:	AKINMULERO, BOLAJI J.		FACILITY TYPE:	735
ADDRESS:	21362 CALORA STREET		TELEPHONE:	(626) 859-4076
CITY:	COVINA	STATE: CA	ZIP CODE:	91724
CAPACITY:	6	CENSUS: 5	DATE:	04/23/2026
		UNANNOUNCED	TIME BEGAN:	11:38 AM
MET WITH:	Kenneth Njoku, Administrator		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Client sustained unexplained injuries due to staff abuse or neglect.
Staff falsified an incident regarding client.
Staff do not ensure that clients are provided an adequate quantity of food.
Staff mishandle client's P&I funds.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced subsequent complaint visit on 04/23/2026 to deliver findings related to the above allegation. LPA met with Administrator Kenneth Njoku and explained the purpose of the visit.

The investigation included a review of the client roster, staff roster, resident face sheets, physician’s reports, Special Incident Reports (SIRs), and a facility walkthrough, including observation of the food supply. In addition, the LPA conducted interviews with four (4) staff members (S1–S4), one (1) witness (W1), and five (5) residents (R1–R5).

(continued on 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Gabriela Castro
LICENSING EVALUATOR SIGNATURE:	DATE: 04/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2026

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-20260408091450

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: MERCY RESIDENTIAL HOME	FACILITY NUMBER: 198600604
	VISIT DATE: 04/23/2026

NARRATIVE

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Allegation: Client sustained unexplained injuries due to staff abuse or neglect.

It is alleged that the client sustained unexplained injuries. During staff interviews, staff reported no observed incidents that could have caused the injuries. Multiple staff indicated that the bruising was discovered without a known cause. Staff stated the client was unable to explain how the injuries occurred and was observed to be acting normally with no complaints of pain. Staff reported the incident to the administrator, and the client was taken for medical evaluation.

It should be noted that, of the five (5) clients interviewed, two (2) were nonverbal and two (2) had cognitive limitations, which impacted their ability to provide information. During client interviews, clients did not report witnessing any incident involving Client 1 (C1). C1 was unable to explain how the injuries occurred and demonstrated limitations in responding to questions. Other clients expressed no concerns regarding staff care or safety within the facility.

.Allegation: Staff falsified an incident regarding client.

It is alleged staff falsified or misrepresented information related to an incident involving C1. During staff interviews, Staff reported that the incident was documented and reported to the appropriate agencies, including the San Gabriel/Pomona Regional Center. No staff indicated that information was altered or falsified. During client interviews Clients did not provide statements that support the allegation.

Allegation: Staff do not ensure that clients are provided an adequate quantity of food.

It is alleged staff do not ensure that clients are provided with an adequate quantity of food. During the initial visit conducted on 04/09/2026, the facility did not have an adequate supply of food available; however, a grocery delivery was observed at the time of the visit. During the current visit conducted on 04/23/2026, the facility was observed to have a sufficient supply of food on hand. During staff interviews, staff reported that meals are prepared daily, often from scratch, and that clients are allowed to request additional portions at any time. Staff stated there are no restrictions on food access and that snacks are available throughout the day upon request. During client interviews, clients reported satisfaction with the food provided. Clients stated they are able to request additional food if desired and have access to snacks. No clients expressed concerns regarding food quantity or availability.

Allegation: Staff mishandle client's P&I funds.

It is alleged that staff mishandle clients’ Personal & Incidental (P&I) funds, including use of funds for items not supported by receipts or proper documentation. During staff interviews, staff reported that the licensee is responsible for managing and reconciling P&I funds. Staff indicated they may assist with distributing funds to clients and documenting transactions but do not oversee financial management. Staff reported no knowledge of discrepancies or concerns.

(continued on 9099C)

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Gabriela Castro
LICENSING EVALUATOR SIGNATURE:	DATE: 04/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2026

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20260408091450

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: MERCY RESIDENTIAL HOME	FACILITY NUMBER: 198600604
	VISIT DATE: 04/23/2026

NARRATIVE

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Allegation: Staff mishandle client's P&I funds (continued).

During client interviews, due to cognitive limitations, only some clients were able to respond to questions. Those who were able to respond reported managing their own money or did not express any concerns regarding staff handling of funds. Other clients were unable to provide responses related to finances. No concerns were reported regarding the mishandling of P&I funds. During the P&I review, LPA observed client ledgers and monies to be up to date.

LPA was in communication with Regional Center San Gabriel/Pomona representatives to confirm whether there were any concerns related to the allegations. No concerns reported.

Based on the investigation conducted, which included interviews with staff, witnesses, and residents, as well as a review of relevant records, there was insufficient evidence to support the reported allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview was held, and a copy of this report was provided.

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Gabriela Castro
LICENSING EVALUATOR SIGNATURE:	DATE: 04/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2026

LIC9099 (FAS) - (06/04)

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