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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603245
Report Date: 10/24/2025
Date Signed: 10/24/2025 10:02:06 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
08/04/2025 and conducted by Evaluator Christian Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250804102812
FACILITY NAME:CASA MARIPOSA-DOLLARFACILITY NUMBER:
198603245
ADMINISTRATOR:DANIELS, VANESSA R.FACILITY TYPE:
735
ADDRESS:2403 DOLLAR STREETTELEPHONE:
(562) 788-7192
CITY:LAKEWOODSTATE: CAZIP CODE:
90712
CAPACITY:4CENSUS: 4DATE:
10/24/2025
UNANNOUNCEDTIME BEGAN:
09:39 AM
MET WITH:Jessica Luna DSPTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Staff do not meet a client's incontinence needs
INVESTIGATION FINDINGS:
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**The purpose of this report is to dismiss a deficiency after 2nd level appeal review. LPA Gutierrez delivered this report.Licensing Program Analyst (LPA) Christian Gutierrez conducted an unannounced subsequent complaint investigation for above allegation. This report supersedes report dated 08/12/2025. The reason for this visit is to change the findings from substantiated to unsubstantiated based on additional information obtained. LPA met with DSP worker Jessica Luna and explained the reason for visit. Administrator Vanessa Daniels was notified via telephone.

On 08/12/2025, LPA Gutierrez requested and obtained copies of staff roster, client roster, client (C1) identification and emergency information, functional capability assessment, and appraisal needs and service plan. LPA conducted interview with Administrator, S2, and C1 over the telephone. LPA Interviewed S1 in person and toured facility. During today's visit LPA delivered new findings. SEE LIC 9099C

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2025
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 2
Control Number 28-AS-20250804102812
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: CASA MARIPOSA-DOLLAR
FACILITY NUMBER: 198603245
VISIT DATE: 10/24/2025
NARRATIVE
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In regard to the allegation” Staff do not meet a client's incontinence needs”, It is alleged that staff are not properly changing C1 and are sending client to program in urine-soaked clothing. During interviews with Administrator and staff it was revealed that C1 did go to program with wet clothes and undergarments, however C1 was asked to change and refused. S2 stated that C1 was asked to change several times but refused because he/she was worried about missing the bus. S2 also stated that the last thing they want to do is argue with a client. During interview with clients C1 stated that he/she did not want to be changed because they did not want to miss the bus. During record review LPA did not find any SIR’s or documents that state this has happened before.

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.

An exit interview was conducted. A copy of the report and appeal rights were provided.

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2