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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602208
Report Date: 10/23/2025
Date Signed: 10/23/2025 05:19:34 PM

Substantiated


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
10/17/2025 and conducted by Evaluator Noemi Galarza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251017144719
FACILITY NAME:ELEANOR RICHARDSON HOMEFACILITY NUMBER:
198602208
ADMINISTRATOR:HOLLAND, TRAVISFACILITY TYPE:
735
ADDRESS:462 E GROVE STTELEPHONE:
(909) 398-4488
CITY:POMONASTATE: CAZIP CODE:
91768
CAPACITY:3CENSUS: 3DATE:
10/23/2025
UNANNOUNCEDTIME BEGAN:
02:07 PM
MET WITH:Jose Alderete, AdministratorTIME COMPLETED:
05:20 PM
ALLEGATION(S):
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Staff make inappropriate threatening gestures towards client.
Staff are not providing adequate food service to clients.
Staff are not following the posted menu
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Galarza conducted an initial 10-day complaint investigation visit regarding the above allegation. LPA discussed the purpose of the visit with staff Andrew Lopez. Administrator Jose Alderete arrived shortly after.

The investigation consisted of: A physical plant tour of the facility was conducted, with special focus on food supply and cleaning suply storage. Three (3) staff and one (1) client were interviewed. Clients (C1 & C2) are not able to communicate and were not interviewed. Record review of client files was completed. A copy of the LIC 500 Personnel Report was obtained. However, the copier is non-operational and none of the client documents were obtained. Administrator was given a list of client pending documents.

*See LIC 9099C for report continuation.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
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 4
Control Number 28-AS-20251017144719
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: ELEANOR RICHARDSON HOME
FACILITY NUMBER: 198602208
VISIT DATE: 10/23/2025
NARRATIVE
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Allegation: Staff make inappropriate threatening gestures towards client. The complaint alleges facility staff get a Windex cleaning solution bottle and point it at two lower functioning clients. It is alleged client (C1) has a disrobing behavior and staff use the cleaning spray bottle to get the resident to stop disrobing their clothes off, and when staff threaten client (C2) with the spray bottle they run to their room. Two (2) out of the three (3) clients are have limited comprehension and/or are non-verbal. Client interview revealed that most of the staff use the spray bottle when the clients are having behaviors. Staff interviews revealed that there are staff that use the cleaning/Windox spray bottle as a redirection technique with client (C2). When staff simply touch the Windex bottle C2 runs away. Interviews revealed staff do not actually spray the clients, but do use the spray bottle to redirect two clients in care. Staff stated they did not know it is a Title 22 violation. Upon arrival to the facility, LPA observed an All Purpose Cleaner with bleach spray bottle unlocked on top of the kitchen counter.

Allegation: Staff are not providing adequate food service to clients. It is alleged that facility staff are not providing sufficient food options to residents in care. A visitor observed there was only bread, cheese, canned beans, and spoiled lettuce in the refrigerator. An outside agency has had to provide groceries for their client/resident (R1), and the resident has also had to spend their money on buying groceries. Staff interviews revealed that grocery shopping is done once a week and typically there is sufficient food, snacks, and there is no spoiled food. However, staff confirmed that on several occasions in recent months the facility did not have enough food or snacks, and staff had to improvise meal preparation due to insufficient food supply. Staff also stated there is always frozen pizza, burgers, and meat that are used if refrigerator food is low in supply. LPA obtained pictures from a 3rd party that confirms that in months June 2025 and August the refrigerator and pantry had little food, and spoiled lettuce. During today's visit, the 2-day perishable and 7-day non-perishable food supply is adequate. However, there is picture evidence supporting the allegation.

Allegation: Staff are not following the posted menu. According to information obtained, the posted menu is not being followed because food items in the refrigerator do not match the posted menu. Staff interviews revealed that the food menu is not always followed because there have been times in which the food item listed is not in the refrigerator, and/or a client has prepared and eaten the food prior to the menu listed day. Staff stated they try to follow the food menu, but sometimes they are unable to because the facility lacks the ingredients required for the meal. Based on picture evidence obtained, the allegation is supported because during months June 2025 and August 2025, the facility refrigerator did not have most of the food item ingredients listed on the food menu.

Based on observation, picture evidence, and interviews the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED.

Exit interview was conducted with Jose Alderete. A copy of the report and appeal rights was provided.

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 28-AS-20251017144719
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: ELEANOR RICHARDSON HOME
FACILITY NUMBER: 198602208
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/31/2025
Section Cited
CCR
80072(a)(1)
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Personal Rights. To be accorded dignity in his/her personal relationships with staff and other persons. This requirement was not met evidenced by:
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Administrator agreed to submit proof of personal rights training and a written plan that addresses policy against staff use of Windex spray bottle as a redirection technique.
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Based on interviews conducted, the findings indicate some staff have used a cleaning spray bottle as a redirection technique towards C1 & C2. his poses a potential health, safety, and personal rights risk to individuals in care.
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Type B
10/31/2025
Section Cited
CCR
85076(d)(1)
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Food Service. The licensee shall meet the following food supply and storage requirements: (1)Supplies of staple nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days shall be maintained on the premises. This requirement was not met evidenced by:
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Administrator agreed to submit a written plan of correction and proof of staff training.

*During today's visit, LPA observed adequate food supply.
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Based on picture evidence obtained, on at least two dates; June 2025 and Aug. 2025 the facility 2-day and 7-day non-perishable food supply was very little, and did not meet Title 22 regulation. This poses a potential health, safety, and personal rights risk to individuals in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 28-AS-20251017144719
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: ELEANOR RICHARDSON HOME
FACILITY NUMBER: 198602208
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/31/2025
Section Cited
CCR
80076(a)(1)
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Food Services. All food shall be safe and of the quality and in the quantity necessary to meet the needs of the clients. Each meal shall meet at least 1/3 of the servings recommended in the USDA Basic Food Group Plan ... All food shall be selected, stored, prepared and served in a safe and healthful manner.
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Administrator shall submit copies of food menus for the next 4 weeks, as well as staff training in USDA Basic food group guidelines.
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This requirement was not met evidenced by:
Based on picture evidence the posted menu in June 2025 and August 2025 was not followed by staff. Pictures depicted none of the food items were available that were supposed to be cooked based on the menu. This poses a potential health, safety, and personal rights risk.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4