198602950-7-14-2026-28-AS-LHIS-DXXT8U-20260915143055

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602950
Report Date: 07/14/2026
Date Signed: 07/14/2026 01:38:41 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
07/08/2026 and conducted by Evaluator Luis DeLeon

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20260708091749

FACILITY NAME:	LAKEWOOD PARK MANOR		FACILITY NUMBER:	198602950
ADMINISTRATOR:	CYNTHIA FLORES		FACILITY TYPE:	740
ADDRESS:	12045 LAKEWOOD BLVD		TELEPHONE:	(562) 923-4417
CITY:	DOWNEY	STATE: CA	ZIP CODE:	90242
CAPACITY:	160	CENSUS: 122	DATE:	07/14/2026
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Administrator Cynthia Flores		TIME COMPLETED:	01:50 PM

ALLEGATION(S):

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Staff are not providing residents with PNI funds.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Luis De Leon conducted an initial unannounced complaint investigation visit for the allegation listed above. LPA met with Activity Director Rebecca Caballero. Activity Director Rebecca Caballero informed administrator Cynthia Flores via phone call of LPA’s visit. LPA explained the purpose of today’s visit and discussed the allegation mentioned above. Administrator Cynthia Flores joined the visit sometime after.

Regarding allegation: Staff are not providing residents with PNI funds.
It is alleged that the licensee is not providing residents with residents’ Personal and Incidental funds (PNI) that are received on the first of every month. Investigation consisted of interviews with staff, residents, and review of R1 facility file, including R1’s Record of Residents Safeguarded Cash Resources (LIC 405). The investigation reveals the following: Interview with residents revealed that nine (9) out of ten (10) residents have received their PNI funds every month.
(Report continues on page LIC-9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Luis DeLeon
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2026

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-20260708091749

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: 07/14/2026

NARRATIVE

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Nine (9) out of ten (10) residents stated that the facility has never refused to give residents their PNI funds. LPA’s record reviews revealed that R1 has collected R1’s PNI funds on 5/4, 5/11, 6/4, and 7/9. R1’s PNI ledger includes R1’s initial confirming PNI funds distributed to R1. One (1) out of ten (10) residents stated that the office has refused to give R2’s PNI funds. However, LPA’s record review for R2 shows that R2 has collected all PNI money each month for 2026. The PNI ledger includes R2’s initials confirming PNI money distributed to R2. Interview with staff revealed that six (6) out of six (6) staff denied the above allegation. Three (3) out of six (6) staff directly involved in the distribution of PNI funds to residents stated that staff have never refused to provide residents with their PNI funds. S1 stated that residents are entitled to their PNI funds because the PNI funds belong to residents. Three (3) out of six (6) staff who are not directly involved in PNI fund distribution stated not to be aware of any resident who has ever complained that the facility has refused to give residents their PNI funds. LPA’s record review of residents LIC 405 revealed that the facility is distributing residents’ PNI fund monthly. Based upon the investigation, resident and staff interviews, document review, and LPA observations, there is insufficient evidence to support the allegation that staff are not providing residents with PNI funds.

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 held with Administrator Cynthia Flores. A copy of the report was provided.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Luis DeLeon
LICENSING EVALUATOR SIGNATURE:	DATE: 07/14/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2026

LIC9099 (FAS) - (06/04)

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