198601976-7-10-2026-28-AS-DSIS-DW2S4X-20260716133328

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601976
Report Date: 07/10/2026
Date Signed: 07/10/2026 04:15:50 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
07/07/2026 and conducted by Evaluator Gabriela Castro

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20260707132840

FACILITY NAME:	DEL MAR PARK		FACILITY NUMBER:	198601976
ADMINISTRATOR:	RABIE BANAFSHEHA		FACILITY TYPE:	740
ADDRESS:	990 EAST DEL MAR BOULEVARD		TELEPHONE:	(626) 577-0215
CITY:	PASADENA	STATE: CA	ZIP CODE:	91106
CAPACITY:	124	CENSUS: 69	DATE:	07/10/2026
		UNANNOUNCED	TIME BEGAN:	09:14 AM
MET WITH:	Denise Sutton, Administrator		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff yelled at resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced complaint investigation visit on July 10, 2026, to deliver findings regarding the above allegation. LPA was greeted by Denise Sutton, Administrator, and facility staff. LPA explained the purpose of the visit.

During the investigation, LPA reviewed and obtained copies of the Resident Roster, Staff Roster, R1's Face Sheet, Physician's Report, and S2's acknowledgment of the facility's client abuse policy. LPA also conducted a tour of the facility and interviewed six (6) staff members (S1–S6) and nine (9) residents (R1–R9).

(continued on 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Gabriela Castro
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2026

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-20260707132840

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: 07/10/2026

NARRATIVE

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Allegation: Staff yelled at resident

It is alleged that S2 yelled at R1 on or about June 29, 2026. During the investigation, R1 stated S2 was "rude and nasty" and that the interaction made them feel upset and uncomfortable; however, R1 was unable to recall the specific words that were used. S2 denied yelling at R1 and stated they were joking with R1 before becoming more direct to encourage them] to prepare for there dialysis appointment. S1 stated they conducted an internal investigation after learning of the allegation, during which no evidence was found to substantiate the concern. S1 further reported there have been no prior concerns, complaints, or disciplinary actions involving S2 related to the treatment of residents. Staff interviews were consistent in that no staff reported witnessing S2 yell at or speak inappropriately to residents. While S3 and S4 stated R1 had told them S2 was "mean," neither witnessed the alleged incident. Residents R2 through R9 stated they feel safe living at the facility, reported that staff treat them with dignity and respect, and expressed no concerns regarding S2.

Based on the investigation conducted, which included interviews with staff and residents as well as 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: 07/10/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2026

LIC9099 (FAS) - (06/04)

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