198602869-6-15-2026-28-AS-LHIS-DVBUAR-20260623152509

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602869
Report Date: 06/15/2026
Date Signed: 06/15/2026 04:55:44 PM

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
06/09/2026 and conducted by Evaluator Bennette Pena

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20260609125348

FACILITY NAME:	JJVITACARE1, INC		FACILITY NUMBER:	198602869
ADMINISTRATOR:	VITANGCOL, MYRABEL		FACILITY TYPE:	735
ADDRESS:	21321 FOUNTAIN SPRINGS ROAD		TELEPHONE:	(909) 641-7109
CITY:	DIAMOND BAR	STATE: CA	ZIP CODE:	91765
CAPACITY:	6	CENSUS: 5	DATE:	06/15/2026
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Florentino Vitangcol - Administrator		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff hit resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced complaint investigation regarding the above-mentioned allegation. LPA met with Alexa Toledo, Direct Support Professional I (DSP I) and explained the purpose of the visit. The administrator, Florentino Vitangcol was called on the phone and arrived soon after to assist with the investigation..

The investigation consisted of the following: LPA obtained a copy of the staff & client rosters, Unusual incident/injury report (06/08/2026), Client #1 (C1) files such as Identification and Emergency Information (Face sheet), Admission agreement, Individual Program Plan (IPP), Medication administration record/MAR for June 2026 and Daily client notes (06/08/2026-06/09/2026). LPA interviewed Staff #1 (S1) - Staff #3 (S3), Staff #4 (S4) telephonically and Client #1 (C1) . LPA attempted to interview Client #2 (C2) - Client #3 (C3) but unsuccessful due to their cognitive abilities. Client #4 (C4) - Client #5 (C5) were out in the day program; therefore not interviewed. *****CONTINUED ON LIC9099-C*****

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026

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-20260609125348

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: JJVITACARE1, INC	FACILITY NUMBER: 198602869
	VISIT DATE: 06/15/2026

NARRATIVE

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The investigation revealed the following:

Allegation: Staff hit resident. It is alleged that staff slapped C1’s hand, when C1 was taking their medications. All staff interviewed denied the allegation, stating that they had never hit or slap a client, and had never seen any other staff do so. Staff stated they received training in personal/clients rights and zero tolerance policy. S4 stated that on the morning of 06/08/2026, S4 was assisting C1 with their prescribed asthma medicine. C1 continued pressing the inhaler, so S4 verbally redirected C1 to stop over-spraying since it wasn't what the doctor had prescribed. According to S4, the day went by as usual after that. Later that day, C1 was assessed by SC at San Gabriel Pomona Regional Center and C1 reported that they were hit by a staff, so SC called the police. Police arrived in the evening and spoke to S4 and C1 but no report was filed and no arrests were made, because C1 did not confirm the allegation and told the police that they could not remember what happened. Staff also stated that C1 is attention seeker and has a history of exaggerating stories to get attention. During the interviews, C1 recanted their story, stating they did not recall what happened and that S4 had never hit or slapped them. C1 also stated that S4 and other staff treat them with respect and they feel safe in the facility. Based on LPA’s observation, there were no visible injuries on C1’s hand. San Gabriel Pomona Regional Center investigated this incident and found the allegation to be unsubstantiated. Therefore, there was insufficient evidence to corroborate with the allegation.

Based on statements and interviews conducted with client and staff as well as reviewed files and documentation, there was not enough supportive evidence to corroborate the allegation.

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.

Exit interview conducted and a copy of this report was provided to Florentino Vitangcol, Administrator.

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2026

LIC9099 (FAS) - (06/04)

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