198603161-5-19-2026-28-AS-LHIS-DUHQJT-20260528121317

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603161
Report Date: 05/19/2026
Date Signed: 05/19/2026 10:58:54 AM

Unfounded

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
05/14/2026 and conducted by Evaluator Alberto Lopez

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20260514095250

FACILITY NAME:	CALIFORNIA MISSION INN		FACILITY NUMBER:	198603161
ADMINISTRATOR:	JARED GREEN		FACILITY TYPE:	740
ADDRESS:	8417 MISSION DR		TELEPHONE:	(626) 287-0438
CITY:	ROSEMEAD	STATE: CA	ZIP CODE:	91770
CAPACITY:	85	CENSUS: 46	DATE:	05/19/2026
		UNANNOUNCED	TIME BEGAN:	10:19 AM
MET WITH:	Maria Releda, Wellness Director		TIME COMPLETED:	10:59 AM

ALLEGATION(S):

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9

Staff are making inappropriate comments in the presence of resident(s) in care.
Staff interrupted the sleep of a resident in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alberto Lopez made initial visit to investigate the above allegations. LPA met with Maria Reledo, Wellness Director and discussed the purpose of the visit.

The investigation consisted of LPA obtaining and reviewing resident and client rosters. Upon further review, LPA noticed that R1 was not on resident roster. LPA confirmed this with staff Maria Reledo, Wellness Director, and by reviewing the resident roster.

Based on the information gathered during visit, the allegation(s) are deemed UNFOUNDED. A finding of UNFOUNDED means that the allegations are either false, could not have happened, and/or are without a reasonable basis.

An exit interview was conducted, and a copy of this report was provided to Maria Roleda, Wellness Director.

Unfounded

Estimated Days of Completion:

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 05/19/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2026

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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