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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602099
Report Date: 12/27/2024
Date Signed: 12/27/2024 01:45:24 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/23/2024 and conducted by Evaluator Mario Leon
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20241223152059
FACILITY NAME:CORAL OAKS CARE LIVINGFACILITY NUMBER:
198602099
ADMINISTRATOR:ELEANOR BARRIENTOSFACILITY TYPE:
740
ADDRESS:4271 CARLIN AVETELEPHONE:
(310) 763-4881
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY:84CENSUS: 65DATE:
12/27/2024
UNANNOUNCEDTIME BEGAN:
11:32 AM
MET WITH:Ellen Barrientos, AdministratorTIME COMPLETED:
02:18 PM
ALLEGATION(S):
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Staff does not ensure to provide a safe environment for residents in care.
INVESTIGATION FINDINGS:
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On 12/27/24 The Department of Social Services, Community Care Licensing Division (CCLD) staff conducted an initial unannounced complaint visit to the facility, to investigate the allegation listed above. CCLD was met by Ellen Barrientos, Administrator (S1), and the purpose of the visit was explained.

The investigation consisted of the following:
On 12/27/24 CCLD toured the facility inside and out with Ellen Barrientos, interviewed four (4) staff (S1-S4) and six (6) residents (R1-R6). LPA Leon requested and reviewed facility documents, including staff and resident rosters, and resident(s) records.

Report continues, see: LIC9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 12/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/27/2024
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 11-AS-20241223152059
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: CORAL OAKS CARE LIVING
FACILITY NUMBER: 198602099
VISIT DATE: 12/27/2024
NARRATIVE
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The investigation revealed the following:

Regarding the allegation: ”Staff does not ensure to provide a safe environment for residents in care.”
It has been alleged that the facility does not intervene between resident altercations or issues. Records review have indicated that there have been zero (0) resident-on-resident altercation(s) between the resident(s) in question. CCLD staff interviewed four (4) staff members and six (6) residents, all of which have denied the allegation has taken place.
According to CCLD's record reviews and interviews conducted, there is not enough evidence to support the above allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred, therefore the above allegation is Unsubstantiated.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 12/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/27/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2