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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198601976
Report Date: 07/24/2025
Date Signed: 07/24/2025 04:40:29 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
07/16/2025 and conducted by Evaluator Luis DeLeon
COMPLAINT CONTROL NUMBER: 28-AS-20250716133904
FACILITY NAME:DEL MAR PARKFACILITY NUMBER:
198601976
ADMINISTRATOR:RABIE BANAFSHEHAFACILITY TYPE:
740
ADDRESS:990 EAST DEL MAR BOULEVARDTELEPHONE:
(626) 577-0215
CITY:PASADENASTATE: CAZIP CODE:
91106
CAPACITY:124CENSUS: 65DATE:
07/24/2025
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Assistant Administrator Denise SuttonTIME COMPLETED:
09:16 AM
ALLEGATION(S):
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Facility is in violation of their fire clearance
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Luis De Leon conducted an unannounced complaint investigation visit for the allegation listed above. LPA met with the Assistant Administrator Denise Sutton and explained the reason for the visit.
The investigation consisted of the following: On today’s visit, LPA De Leon toured the physical plant with Assistant Administrator Denise Sutton. LPA obtained the current client and staff roster, physician reports, list of residents in hospice care, and hospice assessment. Regarding allegation: Facility is in violation of their fire clearance. It is alleged that the facility is retaining bedridden residents in violation of their fire clearance which was only approved for non-ambulatory residents. The fire clearance for bedridden was denied on 11/21/2024. The current fire clearance was approved for 124 non-ambulatory residents only. The investigation revealed that seven (7) out of seven (7) residents denied knowing anyone at facility being bedridden or needing help repositioning on bed.
Report continues on page 9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Luis DeLeon
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2025
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 2
Control Number 28-AS-20250716133904
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: DEL MAR PARK
FACILITY NUMBER: 198601976
VISIT DATE: 07/24/2025
NARRATIVE
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One resident confirmed to need assistance for all activities of daily living, but review of physician reports show identifies resident as non-ambulatory. In addition, a record review of physicians reports for hospice residents revealed that nine (9) out of nine (9) hospice residents’ physicians reports identified residents as non-ambulatory. During facility tour, LPA observed resident R10 to be in bed with half bed rails which physician report identified resident as non-ambulatory. Seven (7) out of seven (7) staff interviews revealed that the facility has no bedridden residents. Some residents were identified as needing repositioning, but record reviews identified residents as being bedbound. Services provided were for transferring, feeding, dressing or showers. Based upon the investigation, client and staff interviews, document review, and LPA observations, the facility is not in violation with their fire clearance.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Exit interview was held with Assistant Administrator Denise Sutton. A copy of the report was provided.
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Luis DeLeon
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2