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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602227
Report Date: 08/13/2026
Date Signed: 08/13/2026 02:52:56 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
08/04/2026 and conducted by Evaluator Perry Scott
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20260804125638
FACILITY NAME:ASAHI RESIDENTIAL CAREFACILITY NUMBER:
198602227
ADMINISTRATOR:KRISTINA FATIMA LACANILAOFACILITY TYPE:
740
ADDRESS:18527 DORMAN AVETELEPHONE:
(310) 327-1633
CITY:TORRANCESTATE: CAZIP CODE:
90504
CAPACITY:6CENSUS: 5DATE:
08/13/2026
UNANNOUNCEDTIME BEGAN:
08:58 AM
MET WITH:Kristina LacanilaoTIME COMPLETED:
03:10 PM
ALLEGATION(S):
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Staff are overmedicating resident.
INVESTIGATION FINDINGS:
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On 8/13/26, at 9:00am, the department conducted an initial complaint visit to the facility and was greeted by Kristina Lacanilao, Administrator. The department explained the purpose of this visit was to gather information about the complaint, gather facility files, interview staff and residents, and deliver findings for the allegation mentioned above.

The investigation consisted of the following: The department interviewed staff (S1-S3) and residents (R2-R5). The department attempted to interview R1 on their cell phone several times and left messages but did not receive a return call. The department also contacted the skilled nursing facility that the resident is in now but was not able to speak to R1. The department requested and received the following documents from the facility: Resident Roster (Dated: 08/11/2026), Personnel Report (Dated: 08/13/2026), Identification and Emergency Information (Dated: 07/16/2026, 05/05/2023, 07/31/2024, 05/01/2026, 08/11/2026), Medical Assessment (Dated: 07/14/2026), Preplacement Appraisal Information......

Report Continued On LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2026
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-20260804125638
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: ASAHI RESIDENTIAL CARE
FACILITY NUMBER: 198602227
VISIT DATE: 08/13/2026
NARRATIVE
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(Dated: 07/16/2026), Admission Record (Dated: 07/15/2026), Medication Administration Record (Dated: 07/17/2026-07/29/2026), Prescription Order (Dated: 07/27/2026), Medication List (Dated: 07/15/2026), and Kei-Ai South Bay Healthcare Discharge Report (Dated: 07/17/2026).

The investigation revealed the following: Allegation- Staff are overmedicating resident.

The details of the complaint allege that facility staff are overmedicating resident. It was reported that a resident was being overmedicated in order to keep them less active. On 8/13/2026, from 9:00am-2:00pm, the department interviewed staff (S1-S3) and residents’ (R2-R5). The department attempted to interview R1 on their cell phone several times and left messages but did not receive a return call. The department also contacted the skilled nursing facility that the resident is in now but was not able to speak to R1.

3 of 3 staff denied the allegation Staff are overmedicating resident. All staff (S1-S3) stated that they have never overmedicated any resident and have always followed the resident’s medication list as prescribed by their physician. Staff (S1) stated that resident (R1) seem to be overly tired after a new medication was prescribed for them but deny that they were over medicating (R1). S1 stated the facility staff gave all medication as prescribed by (R1s) physician and has never overmedicated them to keep them less active. S1 also stated that (R1) was hospitalized recently because they were lethargic, had shallow breathing, and their oxygen saturation level was low at 73%.

The department interviewed residents (R2-R5) about the allegation and 4 of 4 residents stated that they receive their medication as prescribed by their doctor. Residents deny that staff has ever tried to overmedicate them.

The department reviewed the Medical Assessment (Dated: 07/14/2026), Preplacement Appraisal Information (Dated: 07/16/2026), Prescription Order (Dated: 07/27/2026), and Medication List (Dated: 07/15/2026) and observed that the resident is taking several medications that have side effects that cause drowsiness, dizziness, confusion, blurred vision, and lightheadedness. Those medications are Promethazine-dextromethorphan, Furosemide, and Meloxicam. The department also reviewed the Medication Administration Record (Dated: 07/17/2026-07/29/2026) and observed that all prescribed medication was given as prescribed and documented. The department did not find any evidence that the facility was overmedicating the resident.

Based on interviews and records reviewed, there is insufficient evidence to support the allegation that Staff are overmedicating resident. 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.

No citations were issued for this complaint investigation.

An exit interview was conducted with Kristina Lacanilao, Administrator, and a hard copy of this Complaint Investigation Report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 08/13/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2026
LIC9099 (FAS) - (06/04)
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