198601566-1-7-2026-11-AS-SCIS-DS8W2U-20260316165452

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601566
Report Date: 01/07/2026
Date Signed: 01/07/2026 02:29:00 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/29/2025 and conducted by Evaluator Felisa Shirley

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20251229085844

FACILITY NAME:	STUDIO ROYALE		FACILITY NUMBER:	198601566
ADMINISTRATOR:	LEWIS,ERNEST D.		FACILITY TYPE:	740
ADDRESS:	3975 OVERLAND AVENUE		TELEPHONE:	(310) 836-5854
CITY:	CULVER CITY	STATE: CA	ZIP CODE:	90232
CAPACITY:	175	CENSUS: 89	DATE:	01/07/2026
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	William Boles, Excutive Director		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Licensee does not ensure facility is free of pest

INVESTIGATION FINDINGS:

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On 1/7/26, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced visit to this facility. LPA was met by the Executive Director, William Boles, and explained the purpose of the visit is to investigate and deliver findings for the allegations mentioned above. LPA was granted access to the facility.

The investigation consisted of the following:

On 10/2/25 LPA Shirley reviewed copies of the following records: Staff and Resident Roster, and fumigation Invoice/Account Summaries. LPA Felisa Shirley conducted a tour of the facility. LPA Shirley interviewed Staff 1 – Staff- 8(S1 – S8), and Resident -1 – Resident -5 (R1-R5).

Con'd on 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 01/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20251229085844

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: STUDIO ROYALE	FACILITY NUMBER: 198601566
	VISIT DATE: 01/07/2026

NARRATIVE

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The investigation revealed the following:

Allegation: Licensee does not ensure facility is free of pest

It is being reported that there is an infestation of pest at this facility. LPA Felisa Shirley and the Executive Director toured this facility and inspected the kitchen, rooms #210, #211 and #212. Upon inspection, LPA Shirley did not observe any activity of pest. LPA Shirley reviewed fumigation invoice for 12/15/25 and observed that there was full treatment for pest. LPA Shirley also verified weekly pest control services on Tuesdays by Dewey Pest Control by phone with Service Clerk for the dates of 11/18, 11/25, 12/2, 12/9, 12/16, 12/23, and 1/6.

LPA interviewed staff 1 – staff 8(S-1 – S-8). Of those interviewed 7 out of 8 denied the allegation and 1 agreed. LPA interviewed resident 1 – resident 5 (R1 – R5). Of those who interviewed 5 out of 5 denied the allegation.

Based on information gathered, LPA did not find sufficient evidence to support the allegation “Licensee does not ensure facility is free of pest,” therefore, the allegation is unsubstantiated.

No deficiencies were cited for these allegations.

An exit interview was conducted and a copy of this report was provided to the Executive Director, William Boles.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 01/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2026

LIC9099 (FAS) - (06/04)

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