198600789-9-29-2025-28-AS-FFIS-DMXLS4-20251030090003

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600789
Report Date: 09/29/2025
Date Signed: 09/29/2025 03:31:54 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
09/22/2025 and conducted by Evaluator Sanjay Vaid

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250922161004

FACILITY NAME:	JOMERT HOME		FACILITY NUMBER:	198600789
ADMINISTRATOR:	MARIA PLISS		FACILITY TYPE:	735
ADDRESS:	13430 HARVEST AVE		TELEPHONE:	(562) 921-2378
CITY:	NORWALK	STATE: CA	ZIP CODE:	90650
CAPACITY:	4	CENSUS: 4	DATE:	09/29/2025
		UNANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Maria Pliss-Licensee/Administrator		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Licensee did not ensure facility was free from pests.
Licensee did not ensure facility was maintained in good repair.
Licensee did not ensure facility cleanliness was maintained.
Licensee did not ensure facility walkways were free from hazards.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Vaid conducted 10-day complaint investigation. LPA Vaid was allowed entry by Leonila Santos -Direct staff person (DSP) into the facility and administrator arrived shortly after to assist with the complaint. Facility is vendorized through Harbor Regional Center.

The investigation consisted of the following: LPA Vaid requested, obtained and reviewed staff and client rosters, clients #1-#4 face sheet, physicians report and client individual progress(IPP). Interviewed staff #1-#3 and client #1. LPA Vaid toured the facility and did not observe any health and safety concerns.

Regarding the allegation: Licensee did not ensure facility was free from pests. It is alleged that the facility is not ensuring it is free from pests and cockroaches have been observed in the bathroom. (3) of (3) staff interviewed denied this allegation. (1) of (4) clients interviewed could not corroborate the allegation.

CONTINUED ON 9099C...............

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2025

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 3

Control Number 28-AS-20250922161004

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: JOMERT HOME	FACILITY NUMBER: 198600789
	VISIT DATE: 09/29/2025

NARRATIVE

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According to Licensee the facility has pest control company on-call. Last pest control visit did not observe any pest in the exterior and interior of the facility. LPA Vaid closed light in bathroom and waited two minutes in the dark and then turned on the light, no cockroaches were observed in the bathrooms. LPA Vaid checked for pests under the kitchen sink cabinets and did not observe any pests. Based upon observations made and interviews conducted the findings indicate that, although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Regarding the allegation: Licensee did not ensure facility was maintained in good repair. It is alleged that the facility is not maintained in good repair and the plumbing is causing toilets to become backed up and not flush clients’ bowel movements. (3) of (3) staff interviewed denied this allegation. (1) of (4) clients interviewed could not corroborate this allegation. According to the administrator, plumbing in the toilets is good. A client whose stool is very hard at times and does not flush down becomes struck in the toilet bowl. Staff have been instructed as part of their duty is to remove and dispose of bowel movement using double gloves. The client has had their medication adjusted, however due to clients’ behavior and other medications administered the client has had a couple of toileting incidents, noted and communicated to regional center coordinator who is aware of clients ongoing toileting issue. LPA Vaid was able to flush both toilets without incident. Based upon observations and interviews conducted the findings indicate that, although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Regarding the allegation: Licensee did not ensure facility cleanliness was maintained. It is alleged the facility is not maintained with cleanliness and dust is accumulating near medications, and the facility van was not cleaned after client had urinated in the van. (3) of (3) staff interviewed deny this allegation. (1) of (4) clients interviewed could not corroborate the allegation. According to the staff cleaning is performed daily when clients are at their day program, night cleaning is done by sweeping, mopping and dusting when clients are asleep. LPA Vaid did not observe dust in the medication cabinet and no mal odor of urine from the facility van. Licensee showed proof of van detailing bill charge dated 08/30/25. LPA Vaid observed staff cleaning clients’ bedrooms and bathrooms while clients’ they are at day program. Based upon observations, interviews conducted, the findings indicate that, although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. CONTINUED ON 9099C.........

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2025

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20250922161004

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: JOMERT HOME	FACILITY NUMBER: 198600789
	VISIT DATE: 09/29/2025

NARRATIVE

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Regarding the allegation: Licensee did not ensure facility walkways were free from hazards. It is alleged that the facility is not ensuring walkways are free from debris and hazards and staff are blocking walkways leading from street to door by parking their personal vehicles in the way. (3) of (3) staff interviewed deny this allegation. (1) of (4) clients interviewed could not corroborate the allegation. According to staff interviewed, the facility van is the only vehicle parked in the facility driveway. Staff parks their personal vehicles on the road around the facility. During street sweeping days staff will move their personal vehicles around the street. Interviews indicate staff do not park their vehicles in the facility driveway. During the facility tour LPA Vaid did not observe any obstructs or debris blocking the walkways around the exterior of the facility. The staff is aware of two clients that are falling risk and ensure no obstructs are blocking clients’ walking path. Based upon observations and interviews conducted, the findings indicate that, although the allegation may have happened or are 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 conducted and copy of this report was given to Administrator/Licensee Maria Pliss.

Due to printer issues LPA will email report to administrator and mail via USPS.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE:	DATE: 09/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2025

LIC9099 (FAS) - (06/04)

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