198602388-8-5-2025-28-AS-WSHO-DKNQDM-20250818120500

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602388
Report Date: 08/05/2025
Date Signed: 08/05/2025 11:52:08 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
07/28/2025 and conducted by Evaluator Mary G Flores

COMPLAINT CONTROL NUMBER: 28-AS-20250728115149

FACILITY NAME:	EASTER SEALS SOUTHERN CALIFORNIA MOUNTAIN VIEW		FACILITY NUMBER:	198602388
ADMINISTRATOR:	ANDRES ROJAS		FACILITY TYPE:	735
ADDRESS:	3799 MOUNTAIN VIEW AVE		TELEPHONE:	(818) 512-2494
CITY:	PASADENA	STATE: CA	ZIP CODE:	91107
CAPACITY:	4	CENSUS: 4	DATE:	08/05/2025
		UNANNOUNCED	TIME BEGAN:	08:52 AM
MET WITH:	Massoumeh Ho - LVN		TIME COMPLETED:	12:05 PM

ALLEGATION(S):

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Facility’s staff is physically abusing client in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mary Flores conducted an unannounced complaint investigation visit regarding the above allegation. LPA met with Massoumeh Ho. Ernesto Vasquez Director arrived shortly after and LPA explained the reason for the visit.

The investigation consisted of the following: LPA requested a copy of staff/client roster. LPA interviewed 4 staff and 3 clients. LPA attempted to contact Regional Center Service Coordinator over the phone. LPA requested copies of Identification and Emergency sheet, Physician’s Report, Individual Program Plan, Behavioral Plan for client #1-2(C1-C2), C1’s pictures taken on 7/24/25 and 7/25/25, and Resident Council Meeting dated: 7/25/2025, In-Service Training dated: July 25-27, 2025 and In-Service Training dated: 7/30/25

The investigation revealed the following: Regarding allegation: Facility’s staff is physically abusing client in care. It is alleged a client stated a staff pinched the client.
(CONTINUED ON LIC 9099C)

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Mary G Flores
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025

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-20250728115149

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: EASTER SEALS SOUTHERN CALIFORNIA MOUNTAIN VIEW	FACILITY NUMBER: 198602388
	VISIT DATE: 08/05/2025

NARRATIVE

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Interviews conducted with clients revealed 1 out of 3 clients stated a staff has physically hurt them. 2 out of 3 clients stated staff have not hurt them or have not observed staff hurting clients in care. Interviews conducted with staff revealed staff have not observed any staff pinching or hitting clients in care. Staff #2(S2) stated that on 7/24/25 during day program drop off C1 became agitated and was lift their arm. Staff unsure whether C1 was going to hurt self, proceeded to hold C1’s arm only. Per Director, San Gabriel Pomona Regional Center conducted a visit on 7/29/25 regarding the allegation. Documents review revealed, C1 and C2 have a history of making false allegations. Picture taken by Director on 7/24/25 show three red marks on C1’s arm, two around the inside of elbow area and one above the inside of the arm. Director discussed abuse, and personal rights with clients in care during the Council Meeting on 7/25/25 and held Personal Rights in-service training with staff on 7/25/25-7/27/25. Individual training was provided to S2 on Behavior and Reactive Strategies on 7/30/25. Although the allegation may have happened it is not certain the client was pinched by S2 or that the marks were caused by S2 holding C1’s arm. Therefore, the allegation is unsubstantiated.

Although the allegation 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 was conducted with Ernesto Vasquez Director and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Mary G Flores
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/05/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2025

LIC9099 (FAS) - (06/04)

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