198601990-6-15-2026-28-AS-LHIS-DVLLYT-20260702091050

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601990
Report Date: 06/15/2026
Date Signed: 06/15/2026 12:19:13 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
05/21/2026 and conducted by Evaluator Bennette Pena

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20260521104127

FACILITY NAME:	DUNGARVIN CALIFORNIA - NORWALK		FACILITY NUMBER:	198601990
ADMINISTRATOR:	CHRISTINE GRANT		FACILITY TYPE:	775
ADDRESS:	11005 FIRESTONE BLVD UNIT 117		TELEPHONE:	(562) 623-9800
CITY:	NORWALK	STATE: CA	ZIP CODE:	90650
CAPACITY:	30	CENSUS: 17	DATE:	06/15/2026
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Christine Grant – Quality Assurance Manager Lorena Leon – Program Coordinator		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Resident sustained unknown bruises due to staff neglect or physical abuse.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced subsequent visit to investigate the allegation listed above. LPA met with Christine Grant, Quality Assurance Manager and Lorena Leon, Program Coordinator and explained the purpose of the visit.

The investigation consisted of the following: On 05/28/2026, LPA conducted a tour of the facility, obtained copies of the Staff and Client rosters, Staff schedules, Staff training logs (Mandated reporting, Personal rights and Zero tolerance policy), Client #1 (C1)'s files such as: Face sheet/Identification and Emergency Information, Admission agreement, Physician's Report, Appraisal, Risk Management Assessment and Plan, Current IPP, Personal rights, Behavior Care plans, T-logs/Progress notes (May 2026) and Unusual Injury/Incident Reports/SIRs (06/23/2025 and 05/21/2026).

During today's visit, LPA obtained copies of the Staff and Client rosters, Clients attendance report/schedule, Photos of the park bench and email correspondence from FM. LPA interviewed Staff #1 (S1) - Staff #4 (S4), Client #1 (C1) – Client #4 (C4) and Family Member (FM). *****CONTINUED ON LIC9099-C*****

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026

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-20260521104127

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: DUNGARVIN CALIFORNIA - NORWALK	FACILITY NUMBER: 198601990
	VISIT DATE: 06/15/2026

NARRATIVE

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The investigation revealed the following:

Allegation: Resident sustained unknown bruises due to staff neglect or physical abuse. It is alleged that dime sized marks were reportedly seen on C1’s chest on 5/07/2026, and similar bruising was reportedly found on C1’s back on 5/19/2026, both incidents were reported to the director of the day program. All staff interviewed denied the allegation, stating that they would never hit or hurt any client. Staff indicated that the program has a hands off policy and all staff completed training in Mandt, zero tolerance policy and personal rights. (3) of (4) clients interviewed stated that they have not been hit or handled aggressively by any of the staff and they feel safe in the program. All clients interviewed indicated that staff are well trained, helpful and nice to them. Interview with C1 was unsuccessful due to his cognitive abilities and LPA did not observe any visible injuries or bruises on C1. Interview with FM revealed that on 05/21/2026, they figured out that the bruises/marking found on C1's body was caused by the park bench and not due to staff neglect or physical abuse (photos of the park bench provided). According to FM, they reported this immediately to East Los Angeles Regional Center (ELARC) and the Program Director. Documents reviewed revealed that the facility has sufficient staff and has the proper documentation and notes. Moreover, the photos of C1's bruise appeared to be consistent with the pattern and shape of the park bench with deep grooves that were the exact same size. Therefore, there is insufficient evidence to corroborate with this allegation.

Based on statements and interviews conducted with family member, staff, clients, review of client files, photos and facility file records, 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 to Christine Grant, Quality Assurance Manager.

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026

LIC9099 (FAS) - (06/04)

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