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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198601940
Report Date: 01/28/2025
Date Signed: 01/28/2025 01:44:15 PM

Substantiated


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
01/21/2025 and conducted by Evaluator Erik Zaragoza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250121143110
FACILITY NAME:VILLA FLORAFACILITY NUMBER:
198601940
ADMINISTRATOR:ROSALINDA BUENVIAJEFACILITY TYPE:
735
ADDRESS:10932 CARMENITA RD.TELEPHONE:
(562) 941-5249
CITY:WHITTIERSTATE: CAZIP CODE:
90605
CAPACITY:34CENSUS: 28DATE:
01/28/2025
UNANNOUNCEDTIME BEGAN:
09:04 AM
MET WITH:Elizabeth Jaimes - DSPTIME COMPLETED:
01:58 PM
ALLEGATION(S):
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9
Staff have not ensured that a bed bug infestation was eradicated
Staff did not maintain the facility in good repair
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Erik Zaragoza conducted an unannounced initial complaint visit to investigate the allegations listed above. LPA met with Elizabeth Jaimes, Direct Support Staff for the facility, and explained the purpose of the visit. Administrator Joel Alonzo arrived shortly thereafter.

The investigation consisted of the following: LPA interviewed Clients #1 - 6 (C1 - C6), Staff #1 - 2 (S1 - S2), conducted a tour of the facility including units 1 - 4, and also obtained copies of the staff and client roster, along with the most recent invoice for pest control services dated 8/19/2024.

The investigation revealed the following: In regards to the allegation that "Staff have not ensured that a bed bug infestation was eradicated," it is alleged that there has been a bed bug infestation within Unit 1 of the facility that has not been resolved for a year.
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025
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 6
Control Number 28-AS-20250121143110
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: VILLA FLORA
FACILITY NUMBER: 198601940
VISIT DATE: 01/28/2025
NARRATIVE
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During interviews with the clients, four (4) out of six (6) corroborated that they have witnessed bed bugs in the first unit of the facility. One of the residents interviewed stated that they currently have a bed bug infestation in their room, and that they can feel them on their arms at night. Three (3) other residents interviewed stated that they have witnessed bed bugs in the facility, however they believe that the facility is working towards eliminating the bed bug infestation. During interviews with the staff, none of them corroborated the allegation. One of the staff interviewed stated that they are set to have their pest control company conduct a bed bug treatment this coming Thursday 1/30/2025, however they have not had a treatment from the pest control company since the holidays. Bed bug treatments by the pest control company are supposed to be conducted at least once per month. During record review of the most recent invoice from the pest control company, it was shown that the last treatment of the facility for bed bugs was conducted on 8/19/2024.

In regards to the allegation that the "Staff did not maintain facility in good repair," it was alleged that there are some fixtures in the facility that are not operable. During interviews with the clients, two (2) out of six (6) interviewed corroborated the allegation. One of the clients interviewed stated that the bathroom on the first floor of Unit 1 had a broken toilet seat. Another client interviewed stated that there were mattresses left disregarded in the back portion of Unit 2. During interviews with the staff, none of them corroborated the allegation. One of the staff members stated that while there are mattresses located in the rear of Unit 2, they remove bulk trash once every 2 months, and that they will have the discarded mattresses removed in February. During the physical plant tour, LPA observed that the toilet seat on the first floor of Unit 1 was broken, that one of the sink cabinets was missing, and that there were multiple discarded mattresses and a cabinet located in the rear of Unit 2. Pictures were taken of the mattresses and the broken toilet seat.

Based on LPA interviews conducted with the clients and staff, the preponderance of evidence standard has been met for the above allegations, therefore the allegation is found to be SUBSTANTIATED. California Code of Regulations Title 22, Division 6, Chapter 1 is being cited on the attached LIC9099D.

Exit interview was held and a copy of the report along with the appeal rights were provided.
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 6
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
01/21/2025 and conducted by Evaluator Erik Zaragoza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250121143110

FACILITY NAME:VILLA FLORAFACILITY NUMBER:
198601940
ADMINISTRATOR:ROSALINDA BUENVIAJEFACILITY TYPE:
735
ADDRESS:10932 CARMENITA RD.TELEPHONE:
(562) 941-5249
CITY:WHITTIERSTATE: CAZIP CODE:
90605
CAPACITY:34CENSUS: 28DATE:
01/28/2025
UNANNOUNCEDTIME BEGAN:
09:04 AM
MET WITH:Elizabeth Jaimes - DSPTIME COMPLETED:
01:58 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not maintain a comfortable temperature in the facility for residents
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Erik Zaragoza conducted an unannounced initial complaint visit to investigate the allegation listed above. LPA met with Elizabeth Jaimes, Direct Support Staff for the facility, and explained the purpose of the visit. Administrator Joel Alonzo arrived shortly thereafter.

The investigation consisted of the following: LPA interviewed Clients #1 - 6 (C1 - C6), Staff #1 - 2 (S1 - S2), conducted a tour of the facility including units 1 - 4, and also obtained copies of the staff and client roster, along with the most recent invoice for pest control services dated 8/19/2024.

The investigation revealed the following: In regards to the allegation that "Staff did not maintain a comfortable temperature in the facility for residents," it is alleged that the facility's Air Conditioning (A/C) and heating units were not working in Unit 2, causing the unit to have an uncomfortable temperature for the clients.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 28-AS-20250121143110
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: VILLA FLORA
FACILITY NUMBER: 198601940
VISIT DATE: 01/28/2025
NARRATIVE
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During interviews with the clients, none of them corroborated the allegation. LPA interviewed two (2) clients that resident in Unit 2, and both of them stated that the A/C and heating units were operable and that the unit maintains a comfortable temperature. All other clients also denied the allegation. During interviews with the staff, none of them corroborated the allegation. One of the staff stated that Unit 2 does have operable A/C and heating units, and that there have been no issues with the temperature in the unit. Another staff member also denied the allegation. During a tour of Unit 2, LPA found that the temperature in the unit was comfortable and within the required range of 68 Degrees Fahrenheit - 85 Degrees Fahrenheit.

Based on statements and interviews conducted with staff, clients, review of client files and facility file records, there was not enough supportive evidence to concur with the reported allegation. Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview held, and a copy of this report was provided.
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 28-AS-20250121143110
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: VILLA FLORA
FACILITY NUMBER: 198601940
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/29/2025
Section Cited
CCR
80087(a)(1)
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(a) The facility shall be clean, safe, sanitary (...) (1) The licensee shall take measures to keep the facility free of flies and other insects.

This regulation is not met as evidenced by:
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Administrator is to ensure that the facility remains free of bed bugs and other insects at all times. Administrator is to email LPA the facility's plan for their pest control company to treat the rooms of Unit 1 by the POC due date, and also email the invoice of the treatment as well to LPA once they are done.
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Based on interview and record review, LPA determined that the facility has not had been treated in treated in 5 months when Unit 1 has been identified as having a bed bug infestation, which poses a potential health and safety risk to clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 6
Control Number 28-AS-20250121143110
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: VILLA FLORA
FACILITY NUMBER: 198601940
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/21/2025
Section Cited
CCR
80087(a)
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(a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.

This regulation is not met as evidenced by:
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Administrator is to ensure that the facility is clean and in good repair at all times. Administrator is to remove the mattresses in the rear of Unit 2, and repair the toilet seat in Unit 1 along with the sink cabinet, and email LPA photographs of the repairs by the POC due date.
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Based on observation, LPA observed that there are multiple discarded mattresses in the rear of Unit 2, and that the toilet on the first floor of Unit 1 has a toilet seat that has been removed as well as a cabinet on the sink that has been broken, which poses a potential health and safety risk to clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 6