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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198601744
Report Date: 06/16/2026
Date Signed: 06/16/2026 08:03:55 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
06/10/2026 and conducted by Evaluator Gabriela Castro
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260610160018
FACILITY NAME:JOHN AND MARY DUCE CENTREFACILITY NUMBER:
198601744
ADMINISTRATOR:GARCIA, NOEYFACILITY TYPE:
735
ADDRESS:523 N. CHANDLER AVETELEPHONE:
(626) 289-8766
CITY:MONTEREY PARKSTATE: CAZIP CODE:
91754
CAPACITY:6CENSUS: 6DATE:
06/16/2026
UNANNOUNCEDTIME BEGAN:
04:40 PM
MET WITH:Josie Lopez, House Manager & Alex Scott, Administrator TIME COMPLETED:
05:15 PM
ALLEGATION(S):
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Staff did not notify all authorized representatives of medication error
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced complaint visit on 06/16/2026 to deliver findings related to the above allegation. LPA met with Administrator Alex Scott and House Manager Josie Lopez and explained the purpose of the visit.

The investigation included a review of the client roster, staff roster, Special Incident Report (SIR) w/fax confirmation. Additionally, LPA conducted interviews with two staff members (S1-S2).

(continued on 9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Gabriela Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2026
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 2
Control Number 28-AS-20260610160018
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: JOHN AND MARY DUCE CENTRE
FACILITY NUMBER: 198601744
VISIT DATE: 06/16/2026
NARRATIVE
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Allegation: Staff did not notify all authorized representatives of a medication error.

It is alleged that facility staff failed to notify all required parties following a medication error involving C1's prescribed Magnesium Glycinate. During staff interviews, S1 and S2 reported a Special Incident Report (SIR) documenting the medication error was submitted to the Regional Center and Community Care Licensing on 03/30/2026 in accordance with reporting requirements. During record review, LPA obtained a copy of the Special Incident Report (SIR) dated 03/30/2026, along with a fax confirmation verifying that the report had been submitted to the appropriate parties.

Based on the investigation conducted, which included interviews with staff and 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: 06/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2