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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602245
Report Date: 11/17/2025
Date Signed: 12/09/2025 11:44:25 AM

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
11/13/2025 and conducted by Evaluator Elizabeth Irra
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251113125920
FACILITY NAME:GARFIELD VILLAS LLCFACILITY NUMBER:
198602245
ADMINISTRATOR:SANDOVAL, ROSALIEFACILITY TYPE:
740
ADDRESS:1425 N GARFIELD AVETELEPHONE:
(626) 398-3261
CITY:PASADENASTATE: CAZIP CODE:
91104
CAPACITY:40CENSUS: 10DATE:
11/17/2025
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Claudia Carrillo and Rosalie SandovalTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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9
Staff did not meet residents' diapering care needs in a timely manner resulting in injuries.
INVESTIGATION FINDINGS:
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This is an amended version of the original report created on 11/17/25. Licensing Program Analyst (LPA) Elizabeth Irra conducted a subsequent visit to conduct Resident interviews and to review Resident files. LPA met with Claudia Carrillo and discussed the purpose of today’s visit. Rosalie Sandoval arrived at approximately 9:30 A.M..

During the 11/17/25 visit, LPA obtained a copy of the resident and staff rosters, interviewed Staff #1 (S-1) through Staff #3 (S-3) and conducted a tour of this facility. During today’s visit, LPA interviewed Resident #1 (R-1) through Resident #9 (R-9) and reviewed Resident #1 (R-1) through Resident #10 (R-10) files and obtained relevant documentation. LPA was unable to interview Resident #10 (R-10) as R-10 was not present at the time of this visit.

Refer to LIC 9099C for the continuation of this report.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Elizabeth Irra
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2025
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 2
Control Number 28-AS-20251113125920
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: GARFIELD VILLAS LLC
FACILITY NUMBER: 198602245
VISIT DATE: 11/17/2025
NARRATIVE
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Allegation: Staff did not meet residents' diapering care needs in a timely manner resulting in injuries. It has been alleged that residents in rooms 8, 21 and 28 are not receiving incontinence care which has caused the residents to sustain rashes. Per staff interviews, there are no residents at this facility that require incontinence care and are independent in their continence needs. Interviewed staff indicated that this facility does not have room numbers 8, 21 nor 28 at this facility. Resident interviews and reviewed documentation revealed that they (residents) are independent with their toileting needs (do not require assistance nor incontinent care). Interviews and documentation do not corroborate this allegation.

Although the allegation(s) may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview conducted and a copy of this report and appeal were provided to Rosalie Sandoval.
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Elizabeth Irra
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2