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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602950
Report Date: 02/13/2025
Date Signed: 02/13/2025 11:53:43 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
12/27/2024 and conducted by Evaluator Christian Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20241227160505
FACILITY NAME:LAKEWOOD PARK MANORFACILITY NUMBER:
198602950
ADMINISTRATOR:NARINE MERTKHANYANFACILITY TYPE:
740
ADDRESS:12045 LAKEWOOD BLVDTELEPHONE:
(562) 923-4417
CITY:DOWNEYSTATE: CAZIP CODE:
90242
CAPACITY:160CENSUS: 126DATE:
02/13/2025
UNANNOUNCEDTIME BEGAN:
08:53 AM
MET WITH:Ruby Andrade Buisness ManagerTIME COMPLETED:
12:05 PM
ALLEGATION(S):
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9
Staff yell at resident
Staff do not maintain facility in good repair
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christian Gutierrez conducted a subsequent complaint visit in regard to the allegations listed above. LPA met with Business Office Manager Ruby Andrade and explained the purpose of the visit, Acting Administrator Narine Mertkhanyan arrived shortly.

The investigation consisted of the following: During the initial visit conducted on 01/03/2025, LPA Gutierrez toured five bedrooms on the second floor and three bedrooms on the third floor. LPA obtained copies of the following documents: staff roster, resident roster, resident #1 (R1) LIC 601 Identification and emergency information, LIC 602 physicians report, and LIC 603 preplacement appraisal information. On todays visit LPA interviewed residents #2-#10, R1 refused to be interviewed, staff #1-#6 and delivered findings.

See LIC 9099C.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Christian Gutierrez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025
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-20241227160505
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: LAKEWOOD PARK MANOR
FACILITY NUMBER: 198602950
VISIT DATE: 02/13/2025
NARRATIVE
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In regard to the allegation “Staff yell at resident”, it is alleged that staff have yelled at residents in care. During interviews with residents nine (9) out of ten (10) residents stated staff does not yell at them. R5 stated that staff makes them feel safe. During interviews with staff six (6) out of six (6) stated they never yell at residents and have never witnessed any staff yelling at them. S1 stated that if any yelling were to occur, they would speak to both resident and staff and document incident.

In regard to the allegation “Staff do not maintain facility in good repair”, it is alleged that bedroom closet doors and sliding doors on second floor are in disrepair. During interviews with residents nine (9) out of ten (10) residents stated that nothing was broken in their bedrooms. R9 stated that if anything needs to be fixed, they come right away. During interviews with staff six (6) out of six (6) staff stated they repair anything right away if broken. R3 stated that if there are any work orders they are addressed the same day. LPA Gutierrez toured five (5) bedrooms on second floor and three (3) bedrooms on third floor and found no rooms in disrepair.

Based on interviews conducted and records reviewed, there is insufficient evidence to support the allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted, and a copy of this report was given to Narine Mertkhanyan.

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Christian Gutierrez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/13/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2