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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603201
Report Date: 02/27/2026
Date Signed: 02/27/2026 04:01:58 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
02/24/2026 and conducted by Evaluator Mayra Cota
COMPLAINT CONTROL NUMBER: 28-AS-20260224105041
FACILITY NAME:HEART TO HOME RESIDENTIAL FACILTYFACILITY NUMBER:
198603201
ADMINISTRATOR:MINES, JASMINEFACILITY TYPE:
735
ADDRESS:795 E ELIZABETH STTELEPHONE:
(626) 233-0725
CITY:PASADENASTATE: CAZIP CODE:
91104
CAPACITY:6CENSUS: 4DATE:
02/27/2026
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Idalia Guardado, Direct Support StaffTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Staff physically assaulted client.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Mayra Cota, conducted an unannounced 10-day complaint visit to investigate the above-mentioned allegation. LPA met with Idalia Guardado, DSP, and the reason for the visit was explained. Jennifer Torres, Administrator, was informed about today’s visit via telephone call.

The investigation consisted of the following:
LPA, toured the home and obtained copies of staff and resident rosters, conducted interviews with Staff 1 – Staff 5 (S1-S5) and Client 2 (C2). Interviews were also conducted telephonically with Regional Center Personnel 1-2 (P1-P2) and C1’s facility file was reviewed. Facility staff provided LPA with copies of C1’s Facesheet, Individualized Program Plan (IPP) and Behavioral Plan and Reginal Center personnel provided C1’s Behavior Report. LPA, attempted to conduct interviews with C1 and C3, however, C1 is currently hospitalized and C3 did not respond to LPA’s questions. LPA also reviewed S2's file durint visit.
The investigation revealed the following: ******Continues on LIC 9099-C********
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Mayra Cota
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026
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-20260224105041
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: HEART TO HOME RESIDENTIAL FACILTY
FACILITY NUMBER: 198603201
VISIT DATE: 02/27/2026
NARRATIVE
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Regarding: Staff physically assaulted client.

It is alleged that staff physically assaulted client with a broom and that it’s not the first time client has been hit by staff.

Staff deny the allegation. Interviews with (5) out of (5) staff revealed that clients in care are never physically assaulted by staff. Staff indicated that staff do not assault clients with brooms or other objects. Staff also indicated that they have not observed other staff assault clients. Interview with S1 – S3 indicated that C1 was physically aggressive toward S2 during an incident in which S2 and S3 were attempting to pacify C1, after C1 exhibited a mental health crisis in their room. S2 indicated that on 2/23/26, S2 attempted to provide support to C1 after hearing C1 yelling and talking to self in their room. S2 stated that during their attempt to pacify C1 with verbal prompts, C1 attacked S2 by continuously punching S2 on the face. S2 stated that they immediately shielded their face with both arms as they sat on a chair next to C1’s bed. S2 indicated that S2 did not hit C1 back and did not use a broom to assault C1. S2 indicated that they could not conduct Crisis Prevention Intervention (CPI) due to S2 sustaining injury as C1 punched S2 on the face, lips and arms. S2 indicated that S2 has never verbally or physically assaulted C1 or any of the other clients. S2 indicated that S3 tried to help S2 by attempting to move C1 away. S2 stated that C2 came into the room and provided S2 with their phone and called 911 which lead to police visiting the home. Interview with S3 indicated that S3 entered the room with S2 to help pacify C1 and observed C1 launching toward S2 and punching S2 on the face as S2 shielded the punches with their hands and arms. S3 further indicated that S3 attempted to move C1 away from S2 but could not because C1 was too strong to be moved. S3 stated that they also attempted to conduct CPI; however, was unable to due to C1 overpowering the situation. S3 further indicated that during the incident S3 did not observe S2 “fight back” or hit C1 with a broom. Interview with C2 indicated that they observed S2 being punched on the face by C1 as S2 shielded the punches with their arms over their head and face. C1 further indicated that S2 did not “fight back” nor used a broom to assault C1. C1 further indicated that staff do not physically assault clients or behave in any inappropriate manner. Further interviews with S1-S5 indicated that C1 has a history of fabricating information and being physically aggressive toward staff as part of their behavioral tendencies. S1 indicated that S2 has not been excluded from working nor has any disciplinary action been placed. S1 further indicated that S1 has never received reports from clients or other staff indicating inappropriate behavior by S2 toward clients in care.

****Continues on LIC 9099-C page 2****

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Mayra Cota
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20260224105041
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: HEART TO HOME RESIDENTIAL FACILTY
FACILITY NUMBER: 198603201
VISIT DATE: 02/27/2026
NARRATIVE
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Interviews with Regional Center Personnel 1 - 2 (P1-P2) revealed that they have not received reports of misconduct or physical assaults from S2 or any of the staff working at the facility. P1-P2 indicated that they do not have any concerns with the care and supervision of the clients living in the home. P2 indicated that S2 has been interviewed by Regional Center staff and found that S2 knows the protocols and policies to respond appropriately to clients’ behavioral challenges. P1-P2 further indicated that they do not have any record of S2 involved in misconduct toward clients. P2 indicated that C1’s behavioral plan indicates that C1 has a history of fabricating information and being physically aggressive toward staff due to C1’s mental illness.

Review of C1’s Individualized Program Plan (IPP) indicates that C1 has a history of being physically aggressive toward staff. Furthermore, Behavioral Plan provided to LPA by P2 indicates that due to C1’s mental state, C1 tends to fabricate information regarding staffs’ conduct.

Based on interviews conducted with staff, clients and Regional Center personnel and record review, the allegation that staff physically assaulted client with a broom and that it’s not the first time client has been hit by staff could not be corroborated.

Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated. An exit interview was conducted with Jennifer Torres, Administrator, and a copy of this report was provided.

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Mayra Cota
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3