198601943-8-21-2025-28-AS-WSHO-DLP25J-20250919170535

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601943
Report Date: 08/21/2025
Date Signed: 08/21/2025 03:10:48 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
07/14/2025 and conducted by Evaluator Glenn Trueman

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250714152659

FACILITY NAME:	INCLUSION SPECIALIZED PROGRAMS LLC - WILCOX		FACILITY NUMBER:	198601943
ADMINISTRATOR:	RAYMUNDO LOPEZ		FACILITY TYPE:	735
ADDRESS:	8134 WILCOX AVE		TELEPHONE:	(562) 447-0991
CITY:	CUDAHY	STATE: CA	ZIP CODE:	90201
CAPACITY:	3	CENSUS: 3	DATE:	08/21/2025
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Raymundo Lopez		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff are not properly reporting incidents to authorized representatives
Staff are not meeting the needs of the client

INVESTIGATION FINDINGS:

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The purpose of this report is to gather additional information regarding allegations about reporting AWOL to law enforcement and Administrator ignores staff's calls.
At today's visit 8/21/2025 interviews were conducted with Client C1, the Administrator and Staff S1-S3.
The initial visit was conducted on 7/22/2025 and the following was done:
Licensing Program Analyst (LPA) Glenn Trueman conducted the unannounced ten day investigation visit regarding the above allegations. LPA met with Staff Veronica Mendez, and the purpose of the visit was discussed.
During this visit LPA interviewed Client's C1 and C2.
Interviews were conducted with Staff Veronica Mendez and the Administrator was interviewed (telephonically).
Interview was conducted telephonically with Crisis Support Services Representative (telephonically)
File for Client C1 was reviewed and the following was submitted:
Special Incident Report's (SIR's), Individual Program Plan (IPP) and Physician's Report were submitted.
In regards to the allegation Staff are not properly reporting incidents to authorized representatives, based on

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2025

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 28-AS-20250714152659

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: INCLUSION SPECIALIZED PROGRAMS LLC - WILCOX	FACILITY NUMBER: 198601943
	VISIT DATE: 08/21/2025

NARRATIVE

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interviews conducted and information gathered Client C1 stated that when she AWOL's staff tries hard to get her back.
Said staff will tell her come on and lets come back. Said staff will report it to Raymundo.
Representative from South Central Regional Center (SCLARC) stated that the Administrator will do SIR's
everytime Client C1 AWOL's.
Stated that emergency Room visits the Administrator will also notify her.
SIR received by Licensing on 07/13/25.
Staff stated they always have to report AWOL's and anything affecting a client's safety to the Administrator immediately.
Crisis Support Services Representative stated that they have responded to the facility on multiple occasions.
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.

In regards to the allegation Staff are not meeting the needs of the client, based on interviews conducted and information gathered Client C1 stated that staff try hard to keep her from AWOL'ing ad she likes all staff.
Client C2 stated that he has seen several times police bringing back Client C1. Stated C1 has behaviors and just yesterday hit and injured a staff.
Said sometimes she sneaks out and has seen the Crisis Team called out.
Individual Program Plan (IPP) states under current status that Client C1 runs into streets without looking for incoming traffic.
Also states that C1 will leave the facility without permission.
Under Desired Outcome #11 it states that C1 will exhibit zero instances of running away every week in order for her to increase living arrangement stability.
Staff stated that the protocol is to call the Administrator right away if there is an AWOL.
Said if it escalates with Client C1's behaviors they will call the Crisis Team.
Administrator said staff will report to him right away.
Staff said sometimes they follow her for hours, but it is very difficult because C1 will throw rocks at them or hit them.
Stated that 1 staff is on medical leave regarding C1 hitting them.

At today's visit 8/21/25 Client C1 stated that when AWOLing staff will say come back. They also talk to Client C1 and try to have Client C1 not leave.

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 28-AS-20250714152659

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: INCLUSION SPECIALIZED PROGRAMS LLC - WILCOX	FACILITY NUMBER: 198601943
	VISIT DATE: 08/21/2025

NARRATIVE

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Interviews with Staff S1-S3 all stated that the Administrator will always answer the phone.
The staff also texts the Administrator and will get back right away.
All say they will redirect Client C1 and try and get Client C1 to stay calm.
Stated they never let Client C1 just leave. They always follow by foot or van and never tell Client C1 go ahead and leave.
Spoke with Administrator who stated that law enforcement is upset, but they will explain the behaviors of Client C1 and that C1 has personal rights and facility can't restrain or transfer to higher level of care. Have to explain how the assisted living facility operates. Stated they always try to prevent Client C1 from AWOLing and always will follow.
Stated he answers the phone calls from Staff right away and if emergency they text and he responds immediately.

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.

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/21/2025

LIC9099 (FAS) - (06/04)

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