198601838-4-7-2025-28-AS-DSIS-DFQUH2-20250414153513

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601838
Report Date: 04/07/2025
Date Signed: 04/07/2025 12:05:33 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
04/02/2025 and conducted by Evaluator Tena Herrera

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250402131533

FACILITY NAME:	DOWNEY RETIREMENT CENTER		FACILITY NUMBER:	198601838
ADMINISTRATOR:	BRANDIE MENDIBLES		FACILITY TYPE:	740
ADDRESS:	11500 DOLAN AVENUE		TELEPHONE:	(562) 869-2416
CITY:	DOWNEY	STATE: CA	ZIP CODE:	90241
CAPACITY:	252	CENSUS: 133	DATE:	04/07/2025
		UNANNOUNCED	TIME BEGAN:	10:02 AM
MET WITH:	Brandie Mendibles - Administrator		TIME COMPLETED:	12:10 PM

ALLEGATION(S):

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Staff are not addressing smoking on the premises

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced subsequent complaint visit to deliver findings on the above allegation. LPA met with Administrator Brandie Mendibles and explained the purpose of today's visit.

The investigation consisted of the following:
During initial visit conducted on 4/3/25 LPA obtained copies of staff/resident rosters, toured facility 1st and 2nd floors, multiple resident rooms and their balconies, and LPA interviewed 4 staff and 12 residents.
On 4/4/25 LPA conducted a telephone interview.
During todays visit LPA delivered findings to the reported allegation.

(Continued on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: David Sicairos	TELEPHONE: (323) 981-3982
LICENSING EVALUATOR NAME: Tena Herrera	TELEPHONE: 323-980-4633
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2025

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 28-AS-20250402131533

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: DOWNEY RETIREMENT CENTER	FACILITY NUMBER: 198601838
	VISIT DATE: 04/07/2025

NARRATIVE

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The investigation revealed the following:
Allegation: Staff are not addressing smoking on the premises
It is alleged that there is an ongoing issue with smoking on the premises (in non-designated smoking areas) and staff has not tried to enforce the smoking rules. LPA toured facility along side Assistant Administrator Jason Perez, both 1^st and 2^nd floors were toured including a tour of 5 resident rooms. LPA did not observe and odors of smoke during tour nor were there signs of smoking in restricted areas. Upon arrival, and prior to leaving facility LPA observed both the front and rear entrance and did not see any residents smoking in the non-designated areas or near the entrance/exit doors. LPA interviewed 4 staff and 4 out of 4 staff denied the above allegation, some stated they have seen residents begin to smoke in the restricted area in front of the facility but they do remind the residents of the smoking policy and where they are able to smoke, in which residents will comply and move to the appropriate smoking area. LPA interviewed 13 residents and 13 out of 13 residents denied the above allegation stating that facility staff are enforcing the smoking rules and designated areas. Some residents stated that staff were not doing much in the past on enforcing the smoking areas to the residents but within the last two months they have seen a change and confirmed they have observed staff enforcing the rules. 6 of the 13 residents interviewed are smokers and each confirmed they are aware of the smoking areas, try their best to follow the staffs directive on approved smoking areas and have witnessed staff redirect residents when they are smoking in restricted areas.

Based on statements and interviews conducted with staff/residents, and LPA's observations, there was not enough supportive evidence to concur with 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 held, and a copy of this report was provided.

SUPERVISOR'S NAME: David Sicairos	TELEPHONE: (323) 981-3982
LICENSING EVALUATOR NAME: Tena Herrera	TELEPHONE: 323-980-4633
LICENSING EVALUATOR SIGNATURE:	DATE: 04/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2025

LIC9099 (FAS) - (06/04)

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