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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603273
Report Date: 10/09/2025
Date Signed: 10/09/2025 10:40:20 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
10/02/2025 and conducted by Evaluator Daniel Konishi
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251002104803
FACILITY NAME:BRADBOURNEFACILITY NUMBER:
198603273
ADMINISTRATOR:PEREZ, JOEYFACILITY TYPE:
735
ADDRESS:1332 BRADBOURNETELEPHONE:
(855) 302-3331
CITY:DUARTESTATE: CAZIP CODE:
91010
CAPACITY:4CENSUS: 4DATE:
10/09/2025
ANNOUNCEDTIME BEGAN:
10:20 AM
MET WITH:Pedro Malave, DSPTIME COMPLETED:
10:45 AM
ALLEGATION(S):
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Staff hit client in care

INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Daniel Konishi conducted an subsequent unannounced 10-day complaint visit at the facility and met with Direct Support Professional (DSP), Pedro Malave and discussed the purpose of the visit.

On 10/07/2025, the initial investigation visit was conducted. The investigation consisted of the following:

LPA interviewed the Administrator, Staff #1 (S1), Staff #2 (S2), Staff #4 (S4) - Staff #6 (S6), and Client #2 (C2) - Client #4 (C4). LPA interviewed Client #1 (C1) and Witness #1 (W1) over the phone. LPA attempted to interview Staff #3 (S3) over the phone but LPA was unable to interview since S3 did not answer the phone. LPA obtained copies from C1’s file such as Face Sheet, Monthly Behavior Data Sheet, Client Notes and Special Incident Report. LPA also obtained the staff and client rosters.

On 10/07/2025, LPA interviewed S3 over the phone.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Daniel Konishi
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2025
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-20251002104803
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: BRADBOURNE
FACILITY NUMBER: 198603273
VISIT DATE: 10/09/2025
NARRATIVE
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On 10/08/2025, LPA obtained documents from C1’s current Physician’s Report. LPA also obtained copies of Administrator, S1 to Staff #10 (S10’s) valid CPI training certificates.

During today's visit, LPA obtained the following documents: staff roster, client rosters, and Staff #11 (S11's) valid CPI training certificate.



The investigation revealed the following: in regards to the allegation "Staff hit client in care” it is alleged that there is a staff that works the night shift and roughed C1 up which resulted in a black eye. LPA interviewed the Administrator, six (6) out of six (6) staff that denied the allegation stating that the staff have not hit clients while in care nor have they observed any other staff members hit any clients in care. LPA interviewed C1 who stated that the black eye occurred when C1 was out of the community as a result of having a seizure. C1 stated that the black eye did not occur by S3 or another staff hitting C1. LPA reviewed records, per physician’s report dated 05/07/2025, C1 is allowed to leave the facility unassisted. LPA reviewed records of a Special Incident Report dated 10/6/2025 which indicated that local police visited the facility to conduct a welfare check on 10/02/2025 in which C1 stated not knowing how C1 got injuries to the face but confirmed that the injuries occurred while C1 was out in the community. In addition, there were no witnesses that observed the alleged incident. LPA interviewed W1 which stated that C1 has a history of violent behaviors, outbursts, and allegations against staff. LPA interviewed an additional two (2) out of three (3) clients that denied the allegation by stating that they have never been hit by staff nor have they seen staff hit any of the other clients. LPA interviewed one (1) out three (3) clients who stated being grabbed by staff during a behavior. However, staff interview indicated that this was conducted during a CPI hold. LPA reviewed all documentation that C1 has a history of making false statement and fabrications about staff. Administrator, and six (6) out of six (6) staff interviewed indicated that they have used CPI holds on clients in the past if the nature of the situation required it. LPA reviewed records, Administrator, S1 to S11 has valid CPI training certificates. No paperwork observed in the files that showed the staff have been reprimanded for physical abuse. Therefore, there was insufficient evidence to corroborate with the allegations.

Based on statements and interviews conducted with staff, clients, review of client files and facility file records, there was not enough supportive evidence to concur with the reported allegations. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview was held with the DSP, Pedro Malave and a copy of this report was provided.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Daniel Konishi
LICENSING EVALUATOR SIGNATURE:

DATE: 10/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2