198603295-10-16-2025-28-AS-DSIS-DMQRY8-20251023132556

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603295
Report Date: 10/16/2025
Date Signed: 10/16/2025 02:02:06 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
04/18/2025 and conducted by Evaluator Bennette Pena

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250418064403

FACILITY NAME:	PASA ALTA MANOR		FACILITY NUMBER:	198603295
ADMINISTRATOR:	CHERTOK, VLADIMIR		FACILITY TYPE:	735
ADDRESS:	1790 N FAIR OAKS AVENUE		TELEPHONE:	(626) 798-6986
CITY:	PASADENA	STATE: CA	ZIP CODE:	91103
CAPACITY:	90	CENSUS: 83	DATE:	10/16/2025
		UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Estefany Lopez - Administrator		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff sexually abused a client.
Staff harassed a client.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Bennette Penai conducted a subsequent complaint visit to deliver findings regarding the above allegations. LPA met with Administrator, Estefany Lopez and discussed the purpose of the visit.

The investigation consisted of the following: On 04/18/2025, LPA Herrera conducted a Health and Safety check visit and requested a copies of staff/client rosters and inservice staff trainings on personal rights. Prior to today's visit, LPA and Investigations Branch obtained the following files: House rules, Facility floor plan, Staff training about Abusive Conduct (02/25/2025), Mandated Reporter Training (03/01/2025), and Resident Rights Training (02/20/2025). During today's visit, LPA Pena obtained copies of staff & client rosters and delivered findings.

This investigation was completed by Investigator Torre with the Investigations Branch and revealed the following: ******CONTINUED ON LIC9099-C*****

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2025

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-20250418064403

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: PASA ALTA MANOR	FACILITY NUMBER: 198603295
	VISIT DATE: 10/16/2025

NARRATIVE

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In regards to the allegation: “Staff sexually abused a client.” It is alleged that former client (C1) was sexually abused by former staff (S1) while in care of the facility. This investigation was completed by Investigator Torre with the Investigations Branch. Investigation interviews were conducted with facility staff and clients, including C1. The interview of C1 revealed inconsistencies in C1’s statements about the allegation which at first supported the claim but later seemed unsure if C1 had a sexual relationship with S1. (3) current clients interviewed by IB revealed that they never witnessed S1 interacting inappropriately with any of the clients. And (1) staff interviewed revealed they never observed S1 interact inappropriately with any of the clients. Interview with S1 revealed S1 maintained denial of having a sexual relationship with C1. Therefore, at this time, the allegation of C1 was sexually abused by S1 while in care of the facility is Unsubstantiated.

In regards to the allegation: “Staff harassed a client.” It is alleged that former staff (S1) has been harassing former client (C1), who wants to meet and have sex with C1. It is also alleged that C1 refused to and S1 continues to text C1. This investigation was completed by Investigator Torre with the Investigations Branch. Interviews held by IB Investigator were conducted with facility staff and clients, including C1. IB’s interview of C1 revealed inconsistencies in C1’s statements regarding the allegation. At first, C1 confirmed having a sexual relationship with S1 but later seemed unsure. Additionally, C1 was unable to provide text messages they received on social media from S1. IB’s interview of S1 revealed S1 maintained denial of having a sexual relationship with C1 or communicating with C1 on social media. Interview by IB of (3) current clients revealed they had never seen S1 act inappropriately with any of the clients. And (1) staff interviewed revealed they had never seen S1 engage in any inappropriate behavior with any of the clients. Therefore, at this time, there was insufficient evidence to corroborate with this allegation.

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 are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview conducted and a copy of this report was provided to Estefany Lopez, Administrator.

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2025

LIC9099 (FAS) - (06/04)

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