198601046-5-9-2025-31-AS-NMAN-DQ458Z-20260106184448

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601046
Report Date: 05/09/2025
Date Signed: 05/09/2025 01:10:56 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/30/2025 and conducted by Evaluator Raymond Comer

COMPLAINT CONTROL NUMBER: 31-AS-20250430200610

FACILITY NAME:	VENDOME HOME CARE		FACILITY NUMBER:	198601046
ADMINISTRATOR:	ROSE M. T. FONTANILLA		FACILITY TYPE:	735
ADDRESS:	140 SOUTH VENDOME STREET		TELEPHONE:	(213) 427-9976
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90057
CAPACITY:	6	CENSUS: 5	DATE:	05/09/2025
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Leticia Gomez		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff do not provide adequate food service-
Staff do not keep the facility free of pests-
Staff do not treat residents with dignity or respect-
Facility bathroom is in disrepair-

INVESTIGATION FINDINGS:

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

Today, Friday, 5/09/25, at 9:20 am, Licensing Program Analyst, (LPA) Raymond Comer, conducted an unannuouned, initial10- day visit to investigate the above allegation(s). LPA met with Administrator, Leticia Gomez, presented official CDSS badge identification, and reason for the visit was disclosed.

At 9:45 am, LPA conducted a physical plant tour; no health and safety issues were observed.

To investigate the allegations, LPA received facility resident roster, and staff roster. From 10:05 am to 11:45 am, LPA conducted facility observations, and interviews with residents and staff.

Allegation: Staff do not provide adequate food service - The reporting party (RP) alleges that not enough food is provided to residents and that food is "spoiled and rotten".

[LIC9099C] Continued---

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2025

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 31-AS-20250430200610

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: VENDOME HOME CARE	FACILITY NUMBER: 198601046
	VISIT DATE: 05/09/2025

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

LPA toured the facility and made the following observations: Facility maintains two (2) refrigerators filled with a variety of fresh fruits, vegetables, meats and breads. Perishables were labelled and dated; no foods were found to be expired, nor spoiled. Non-perishables (Canned goods and emergency food) were observed in the kitchen pantry and not expired.
LPA conducted interviews with four (4) out of five (5) total residents which revealed the following: Four (4) out of four (4) residents interviewed state that staff provide food and drink sufficient for residents. Residents state that food is of good quality and variety satisfying varied residents tastes.

Based on the LPA observations, and interviews with residents and staff, there is insufficient evidence to corroborate the allegation that staff do not provide adequate food service. Therefore, the allegation is deemed Unsubstantiated at this time.

Allegation: Staff do not keep facility free of pests- The reporting party (RP) alleges that spiders and cockroaches were observed in residents bedrooms.
LPA toured the facility's interior and exterior which revealed the following: No pests, nor vermin were witnessed at the time of LPA's observation. All resident bedrooms were observed by LPA; no pests, nor vermin were seen. Records reviewed by LPA show facility is serviced by a commercial pest control vendor. Records indicate pest control vendor provides scheduled monthly monitoring and pest control treatment of facility. LPA observed multiple glue traps which appeared as recently installed and free of trapped pests.

LPA conducted interviews with four (4) out of five (5) total residents which revealed the following: Four (4) out of four (4) residents interviewed state that facility does not have an issue with pests and proclaim that facility is clean and well maintained by staff.

Based on LPA observations, and interviews with residents and staff, there is insufficient evidence to corroborate the allegation that staff do not keep facility free of pests. Therefore, the allegation is deemed Unsubstantiated at this time.

[LIC9099C] Continued---

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20250430200610

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: VENDOME HOME CARE	FACILITY NUMBER: 198601046
	VISIT DATE: 05/09/2025

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

Allegation: Staff do not treat residents with dignity or respect- The reporting party (RP) alleges that staff "scream" at residents while in care.

LPA conducted interviews with four (4) out of five (5) total residents which revealed the following: Four (4) out of four (4) residents interviewed state that staff treat residents respectfully, and that residents' privacy and freedoms are valued by staff.

Based on LPA observations, and interviews with residents and staff, there is insufficient evidence to corroborate the allegation that staff treat residents with indignity or disrespect. Therefore, the allegation is deemed Unsubstantiated at this time.

Allegation: Facility bathroom is in disrepair- The reporting party (RP) alleges that facility bathroom does not work properly.

LPA toured the facility and made the following observations: Facility maintains two (2) restrooms. Both restrooms were found by LPA to be clean, toilets, sinks and tub faucets working properly with no leaks, and hot water was tested having an appropriate temperature of 110°F. Towels and washcloths are not shared.
LPA conducted interviews with four (4) out of five (5) total residents which revealed the following: Four (4) out of four (4) residents interviewed state that restrooms function properly and consistently, and expressed no concerns.

Based on the LPA observations, and interviews with residents and staff, there is insufficient evidence to corroborate the allegation that staff treat residents with indignity or disrespect. Therefore, the allegation is deemed Unsubstantiated at this time.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 3