198603227-7-3-2026-28-AS-DSIS-DVYMYX-20260714100212

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603227
Report Date: 07/03/2026
Date Signed: 07/03/2026 10:46:39 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
05/11/2026 and conducted by Evaluator Christian Gutierrez

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20260511094100

FACILITY NAME:	WATERS PLACE		FACILITY NUMBER:	198603227
ADMINISTRATOR:	WATERS, LUTHER		FACILITY TYPE:	735
ADDRESS:	2177 WHITE ST		TELEPHONE:	(626) 696-3910
CITY:	PASADENA	STATE: CA	ZIP CODE:	91107
CAPACITY:	3	CENSUS: 3	DATE:	07/03/2026
		UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Keith Nauls		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Staff did not prevent a client from punching another client in the face
Staff did not prevent a client from having access to a hazardous item
Staff threatened the client

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christian Gutierrez conducted an unannounced subsequent complaint visit in response to the above allegations. LPA met with Assistant Administrator Keith Nauls who assisted with today’s visit. Administrator Luther Waters was out of town.

The investigation consisted of the following: During the initial visit conducted on 05/19/2026 LPA conducted a tour of the facility and obtained copies of the following documents: Staff roster, client roster, client #1 (C1) Individual person plan (IPP), physicians’ report (LIC 602), and special incident reports (SIR) for C1 and C2.On todays visit LPA interviewed staff #1-staff #2 (S1-S2), staff #3 (S3) over telephone, clients #1-Clients #3 (C1-C3) and delivered findings.

SEE LIC 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2026

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-20260511094100

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: WATERS PLACE	FACILITY NUMBER: 198603227
	VISIT DATE: 07/03/2026

NARRATIVE

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In regard to the allegation” Staff did not prevent a client from punching another client in the face”, It is alleged that staff did not prevent C2 from hitting C1 in face. During interview with staff, three (3) out of three (3) stated that C1 was pinching C2 and that C2 became enraged. S1 stated that they were trying to redirect C2 to the shower but C1 came over to where they were at and C2 reached over S1 and hit C1. S1 and S2 both stated that they separated the clients and were able to de-escalate the situation. LPA obtained copy of IPP report dated 08/18/2023 at it indicated C1 has a history of disruptive behaviors toward others, including verbal aggression, bullying, stealing items, making threats, emotional outburst, and noncompliance. During interviews with clients C1 stated that staff was there when incident happened and stopped the altercation, C3 stated he/she was not a home and has never witnessed any altercations like that, and C2 could not answer the question.

In regard to the allegation” Staff did not prevent a client from having access to a hazardous item”, It is alleged that a client tried to stab staff. During interview with staff, three (3) out of three (3) all stated that never happened. S2 stated they had been working at the facility for four years and nothing like that has happened. LPA conducted walk-through and observed knives locked in closet and did not see any dangerous or hazardous items accessible to clients. During interviews with clients three (3) out of three (3) stated that they have never witnessed a client trying to stab a staff. C1 stated that he/she heard about it but didn’t see it.

In regard to the allegation” Staff threatened the client”, It is alleged that staff threatened to do something bad to C1 if he/she called cops. During interview with staff three (3) out of three (3) indicated that no staff has ever threatened a client in care. Staff did state they have to redirect the clients if they are having a behavior issue. During interviews with clients three (3) out of three (3) stated that staff has never threatened them. C1 stated “not here” there nice. During interview with C1 it was stated cops were called and that staff stated don’t press charges he/she has special needs.

“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. A exit interview was conducted, and a copy of this report was given to Keith Nauls.

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2026

LIC9099 (FAS) - (06/04)

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