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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602614
Report Date: 07/23/2026
Date Signed: 07/23/2026 03:25:04 PM

Substantiated


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
06/11/2026 and conducted by Evaluator Perry Scott
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20260611170748
FACILITY NAME:PRIME OPTIONS CARE INCFACILITY NUMBER:
198602614
ADMINISTRATOR:NGUYEN, HAIFACILITY TYPE:
735
ADDRESS:2041 W 162ND STTELEPHONE:
(310) 678-6784
CITY:TORRANCESTATE: CAZIP CODE:
90504
CAPACITY:5CENSUS: 4DATE:
07/23/2026
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Hai NgyuenTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Resident sustained multiple bruises due to staff neglect or physical abuse.
INVESTIGATION FINDINGS:
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On 6/17/26, at 1:30pm, the department conducted an initial complaint visit to the facility and was greeted by Hai Nguyen, Licensee. The department explained the purpose of this visit was to gather information about the complaint, gather facility files, interview staff and clients, and deliver findings for the allegation mentioned above.

The investigation consisted of the following: The department toured the facility and interviewed staff (S1-S4). A subsequent visit was conducted on 07/23/2026 to interview clients (C1-C3) and to deliver findings for the complaint investigation. The department requested and received the following documents: Resident Roster (Dated: 05/01/2025), Staff Roster (Dated: 05/01/2026), Identification and Emergency Information (Dated: 04/01/2025), Medical Assessment (Dated: 09/22/2025), Harbor Regional Individual Program Plan (Dated: 09/25/2023), Needs and Service Plan (Dated: 04/21/2023), Semi-Annual Behavior Assessment (Dated: 03/22/2026), Memorial Hospital of Gardena After Visit (Dated: 06/09/2026), and other pertinent documents from the facility.

Report Continued On LIC9099-C

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026
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 11-AS-20260611170748
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: PRIME OPTIONS CARE INC
FACILITY NUMBER: 198602614
VISIT DATE: 07/23/2026
NARRATIVE
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The department further reviewed the Harbor Regional Individual Program Plan (Dated: 09/25/2023) that states C1 needs constant supervision and is unable to be left alone. The report states further that Prime Options and the behavior consult feel that C1 would benefit from a 1:1 staff support. As of 7/23/26 the department observed that a 1:1 staff support for C1 is available during the day but not at night, there isn’t any 1:1 support and the nighttime ratio is one staff to four clients (1:4) when the incident happened. The department also observed that C1 has a history of physical aggression, property destruction, self-injurious behavior, noncompliance, dropping to the ground, and elopement.
Based on interviews conducted and records reviewed, the preponderance of evidence standard has been met. Therefore, the above allegation: Resident sustained multiple bruises due to staff neglect or physical abuse, is found to be Substantiated. California Code of Regulations, Title 22, Division (6) and chapter (1) are being cited on the attached LIC 9099D. 80078(a) Responsibility for Providing Care and Supervision.

Note: *Citations not cleared by the due date of 08/06/2026 will have a $100 fine assessed for each citation until it is cleared per day. Civil penalties will continue to accrue until Proof of Corrections (POC) is cleared. *An immediate civil penalty was assessed today*

Deficiencies are issued and plans of corrections were discussed.

An exit interview was conducted with Hai Nguyen, Licensee, and a hard copy of this Complaint Investigation Report was provided.

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

DATE: 07/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 11-AS-20260611170748
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: PRIME OPTIONS CARE INC
FACILITY NUMBER: 198602614
VISIT DATE: 07/23/2026
NARRATIVE
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The investigation revealed the following: Allegation- Resident sustained multiple bruises due to staff neglect or physical abuse.

The details of the complaint alleged that client (C1) was observed with two black eyes and a hematoma on the top of their head. It was reported that staff were asked what happened and staff stated they didn’t know, then later they said that C1 fell off of their bed and landed between the bed and the wall. On 6/17/2026, from 2:00pm-5:30pm, the department interviewed staff (S1-S4) and on 07/23/2026 the department attempted to interview clients (C1-C3) regarding the allegation. 4 of 4 staff denied the allegation that Resident sustained multiple bruises due to staff neglect or physical abuse. All staff (S1-S4) stated that C1 tends to be very active and hyper throughout the day and night. Staff stated that initially they noticed a small bruise on C1s eye, then it began to get larger. Staff stated they took C1 to the hospital and C1 was diagnosed with widespread facial soft tissue swelling and a large scalp hematoma overlying left parietal bone. Staff (S1) stated that you have to keep a close eye on C1 and that C1 has a history of self-injurious behavior. S1 also stated that C1 has limited safety awareness, has a history of head banging their head on their wall, and property destruction.

When asked about their staff to client ratio, S1 stated that they have a ratio of one staff to two clients (1:2). When asked when the injury happened, S1 stated it happened during the night shift and the ratio of staff to client was one staff to four clients (1:4). S1 also stated that C1 does have 1:1 support during the day but not at night.

The department attempted to interview clients (C1-C3) about the allegation and 3 of 3 clients were not able to participate in the interview process due to cognitive difficulties.

The department reviewed the Needs and Service Plan (Dated: 04/21/2023) and it stated that C1 needs to be supervised at all times and needs support to maneuver their way in their home, community, and day program. The department reviewed the Semi-Annual Behavior Assessment (Dated: 03/22/2026) and it stated that C1 would benefit tremendously from having a 1:1 support staff to help C1 work on their behaviors and adaptive skill development. Additionally, it would provide support to maximize their life skills and abilities, decrease their behaviors, and further develop their social and communication skills.

Report Continued On LIC9099-C
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 11-AS-20260611170748
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: PRIME OPTIONS CARE INC
FACILITY NUMBER: 198602614
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/23/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/06/2026
Section Cited
CCR
80078(a)
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80078 (a) Responsibility for Providing Care and Supervision: (a) The licensee shall provide care and supervision as necessary to meet the client's needs. This requirement was not met as evidenced by:
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The licensee will read Title 22 Regulations 80078 (a) Responsibility for Providing Care and Supervision, and provide in-service training to all staff, and provide proof of training with dates and signatures of those that attended and the trainer to CCLD. Additionally, the licensee shall submit a written plan of corrections outlining how the facility and staff plan to care for C1 that addresses their behaviors, physical aggression, and their need for constant supervision to prevent future injuries to the client. The plan of corrections should be emailed to LPA Perry Scott at perry.scott@dss.ca.gov to avoid monetary penalties by the due date of 08/06/2026. *An immediate civil penalty was assessed* $500.00
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Based on interviews conducted, and documents reviewed, the licensee failed to provide the proper supervision for client (C1). Client was observed sleeping by staff with their head wedged between a wall and their bed, according to an incident report submitted to Community Care Licensing Division on 06/10/2026. C1 was taken to the hospital and diagnosed with widespread facial soft tissue swelling and a large scalp hematoma overlying left parietal bone. The facility failed to have proper care and supervision for a client that needs constant supervision, which poses a potential health and safety 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.
SUPERVISOR'S NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 4