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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602585
Report Date: 04/30/2026
Date Signed: 04/30/2026 01:38:31 PM

Substantiated


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
04/23/2026 and conducted by Evaluator Bennette Pena
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260423113414
FACILITY NAME:CENTER FOR BEHAVIORAL CHANGE #5FACILITY NUMBER:
198602585
ADMINISTRATOR:LATONYA KINGFACILITY TYPE:
735
ADDRESS:2111 EAST GARVEY AVE NORTHTELEPHONE:
(626) 502-1424
CITY:WEST COVINASTATE: CAZIP CODE:
91791
CAPACITY:4CENSUS: 4DATE:
04/30/2026
UNANNOUNCEDTIME BEGAN:
09:43 AM
MET WITH:LaTonya King - AdministratorTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Staff are not providing adequate supervision to residents in care.
Staff do not administer resident's medication in a timely manner.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced complaint visit regarding the
above stated allegations. LPA met with LaTonya King, Administrator and explained the reason for the visit.

Investigation consisted of the following: LPA obtained copies of the staff & client rosters, Staff
schedule, staff in service training logs such as Client Rights and Medication Administration, Client #1 (C1) files such as Emergency and Identification Information (Face sheet), latest IPP, Medication administration record (MAR) for Feb-Apr 2026 and other relevant documents pertaining to the investigation. LPA interviewed Staff #1 (S1) - Staff #3 (S3), Client #1 (C1) - Client #2 (C2) in person. LPA attempted to speak with Staff #4 (S4) - Staff #5 (S5) telephonically 3x but no answer received. LPA also interviewed Service Coordinator (SC) at San Gabriel Pomona Regional Center. *****CONTINUED ON LIC9099-C*****


Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
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 4
Control Number 28-AS-20260423113414
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: CENTER FOR BEHAVIORAL CHANGE #5
FACILITY NUMBER: 198602585
VISIT DATE: 04/30/2026
NARRATIVE
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The investigation revealed the following:

Allegation: Staff are not providing adequate supervision to residents in care. It is alleged that all night shift staff fall asleep. Some staff interviewed stated they had not worked the night shift and denied seeing any staff member asleep. Staff stated they received training in supervision and safety procedures, as well as clients’ rights. Interview with S1 revealed that S5 was written up for sleeping during shift. Additionally, S1 stated that a written disciplinary action had been taken against S4–S5 and they had received a warning for unsatisfactory performance. S1 also confirmed the night shift staff in the photos sleeping and stated a zero tolerance policy about being neglectful of the clients. C1-C2 corroborated the allegation, stating they witnessed S4-S5 asleep and snoring on the sofa frequently while on night duty. The Regional center confirmed that there is no on-going investigation and did not receive a similar complaint. Documents review indicated S4-S5 did not adhere to the client’s supervision needs or care plans. Therefore, there is sufficient evidence to corroborate the allegation.

Allegation: Staff do not administer resident's medication in a timely manner. It is alleged that night shift staff give clients’ medicine late. Some staff interviewed stated they had not seen the night shift staff administer medication late because it was after their shift. S1 confirmed that due to different reasons, some staff members administered medications late or committed medication error. S1 indicated that staff members document daily notes and the MAR in addition to reporting medication mistakes to them. All staff interviewed confirmed that they completed medication training and agreed that a medication is considered late if it is administered more than one hour before or after the scheduled time. C1-C2 corroborated the allegation, stating they are often given their medication late, especially during the evening and bedtime medication passing. The Regional center confirmed that there is no on-going investigation and did not receive a similar complaint. Documents reviewed showed that CCLD received incident reports of medication errors. Therefore, there is sufficient evidence to corroborate the allegation.

Based on statements and interviews conducted with clients and staff as well as reviewed files and documentation, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Deficiencies cited on the attached LIC 9099D.

An exit interview was conducted, and a copy of this report was provided to LaTonya King, Administrator along with the Appeal Rights.

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 28-AS-20260423113414
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: CENTER FOR BEHAVIORAL CHANGE #5
FACILITY NUMBER: 198602585
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/30/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/01/2026
Section Cited
CCR
80075(b)(5)(B)
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80075 Health Related Services..(b) Clients shall be assisted as needed with self-administration of prescription and nonprescription medications. (5) If the client's physician has stated in writing that the client is unable to determine his/her own need for nonprescription PRN medication, but can communicate his/her symptoms clearly, facility staff designated by the licensee shall be permitted to assist the client with self-administration, providing all of the following requirements are met: (B) Once ordered by the physician the medication is given according to the physician's directions.
This requirement is not met as evidenced by:
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Administrator to ensure that medications are given to clients according to physician's directions. Administrator to conduct medication training to staff and submit in service medication training log signed/dated by the staff to CCLD/LPA by POC due date.
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Based on interviews, records review, the Administrator did not comply with the section cited above in which staff members failed to administer medications for C1-C2 in a timely manner which poses an immediate health, safety or personal rights risk to clients 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: Bennette Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 28-AS-20260423113414
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: CENTER FOR BEHAVIORAL CHANGE #5
FACILITY NUMBER: 198602585
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/30/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/08/2026
Section Cited
CCR
85065.6(b)
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85065.6 Night Supervision (b) employees providing night supervision from 10:00 p.m. to 7:00 a.m., as specified in (c) through (f) below, shall be available to assist in the care and supervision of clients in the event of an emergency, and shall have received training in the following:
This requirement is not met as evidenced by:
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Administrator to ensure that NOC shift staff are always available to assist in the care and supervision of clients, especially at night. Administrator to send a plan of correction to prevent future occurrences to CCLD/LPA by POC due date.
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Based on interviews, records review, the Administrator did not comply with the section cited above in which (2) NOC shift staff failed to provide adequate care and supervision to clients during the night shift which poses a potential health, safety or personal rights risk to clients 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: Bennette Pena
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 4