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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603035
Report Date: 01/12/2026
Date Signed: 01/12/2026 02:31:06 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
01/08/2026 and conducted by Evaluator Nune Margaryan
COMPLAINT CONTROL NUMBER: 28-AS-20260108165948
FACILITY NAME:PUENTE HOMEFACILITY NUMBER:
198603035
ADMINISTRATOR:MELISSA VAZQUEZFACILITY TYPE:
737
ADDRESS:1423 E PUENTE AVETELEPHONE:
(626) 331-6331
CITY:WEST COVINASTATE: CAZIP CODE:
91791
CAPACITY:4CENSUS: 4DATE:
01/12/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Reyna SolisTIME COMPLETED:
02:40 PM
ALLEGATION(S):
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Staff did not administer medication to a resident in care.
Staff emotionally abused a resident in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Nune Margaryan conducted a complaint visit to investigate the allegations listed above. LPA met with Reyna Solis. Administrator arrived shortly after and assisted with the visit. Reason for the visit was explained.

The investigation consisted of the following: LPA Margaryan requested Staff and Clients rooster, conducted interviews with Administrator, Staff 1, Staff 2 (S1, S2) and Client 1, Client 2 (C1, C2). At the time of visit C2 was at the day program and was interviewed over the phone. LPA also reviewed C1's file and obtained copies of relevant documents.

Continue 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2026
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 3
Control Number 28-AS-20260108165948
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: PUENTE HOME
FACILITY NUMBER: 198603035
VISIT DATE: 01/12/2026
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Regarding the allegation: Staff did not administer medication to a resident in care. It was alleged that Client haven’t gotten their bedtime medication. Interviewed Administrator and staff denied the allegation. Interviewed Administrator stated that staff are doing their job correctly and followed appropriate procedures of medication administrating. Interviewed Administrator and staff stated that all medications are administrated on time as prescribed and are noted electronically through a "Quick MAR" program. All clients medications are registered under the "Quick MAR" program and administered on a consistent schedule. Staff said that there are occasions on which clients refuse or miss their medications. When clients refuse or miss their medication, it is documented and the reason why the medication was missed or refused. Interviewed staff stated that medications may be administrated up to one hour before or one hour after the scheduled time and are still considered given on time unless client refuse the medication. Staff demonstrated to LPA how is "Quick MAR" program works. LPA observed that C1 refused 8pm medication on 01/02/25. LPA reviewed "Quick MAR", Facility shift notes, SIR for C1 and observed that medication refusal was properly documented. Copies of documents were provided to LPA at the time of visit. Clients interviewed could not corroborate the allegation. Interviewed C1 and C2 stated to be receiving their medications on time and don't have any concerns about this matter. C1 stated that they can not recall the name the staff who administrate medications, but indicated that they getting their medications on time. Interviews conducted and document reviewed do not corroborate this allegation.

Regarding the allegation: Staff emotionally abused a resident in care. It was alleged that staff wasn't being professional and was giving emotional distress and put their hands on client prior. Interviewed Administrator and staff denied the allegation. They stated staff didn't abuse clients in care, physically, mentally nor emotionally. They stated that they always treat clients with respect and dignity and will never emotively distress clients and will never "put hands on clients". Interviewed Administrator and staff stated that facility staff did not emotionally distress C1 or other clients. The staff remained professional and respectful toward the client in any situation. Administrator stated that they didn't hear any complaints about S1 or other staff "putting their hands" on C1 or other clients. Interviewed S1 stated that they have never emotionally distressed C1 or other clients and have never "put their hands on C1". interviewed S2 stated that they did not witness nor hear of any staff emotionally distressed C1 or "put hands on C1".

Continue 9099C

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20260108165948
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: PUENTE HOME
FACILITY NUMBER: 198603035
VISIT DATE: 01/12/2026
NARRATIVE
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Interviewed Administrator and staff stated that C1 has a history of making false allegations which monitored and documented by staff (Copies of Antecedent Behavioral Consequence Data and Shift notes were provided). At the time of visit LPA collected and reviewed documentation pertaining to C1. Per C1's IPP and IBSP report, it stated that C1 making false allegations regarding peers or staff when she does not get her way. Allegations made can be thought verbal statement, written statements, letters, calls. LPA interviewed 2 clients today. Clients stated the staff are nice and do not emotionally distress them and didn't "put hands on them". They also stated they feel comfortable living there. During interview with C1, C1 did not indicate that staff are emotionally distressed and "put their hands on C1" C1 stated that staff are nice and respectful. Interviews conducted and document reviewed do not corroborate this allegation.

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.

Exit interview was conducted and the copy of this report was provided to Administrator.

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 01/12/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2026
LIC9099 (FAS) - (06/04)
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