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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603328
Report Date: 06/16/2026
Date Signed: 08/03/2026 10:43:49 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
02/23/2026 and conducted by Evaluator Sanjay Vaid
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260223144352
FACILITY NAME:A FAITHFUL HOME OF COVINAFACILITY NUMBER:
198603328
ADMINISTRATOR:DUONG, THANGFACILITY TYPE:
740
ADDRESS:1084 W GROVECENTER ST.TELEPHONE:
(626) 244-9999
CITY:COVINASTATE: CAZIP CODE:
91722
CAPACITY:6CENSUS: 4DATE:
06/16/2026
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Glen Oriemo, Lead Care GiverTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff did not seek medical attention for resident.
Staff did not provide adequate supervision to residents in care.
Staff has inappropriate interaction with resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Vaid conducted subsequential visit to the facility and was met by lead caregiver- Glen Oriemo explained the reason for the visit, administrator was notified. Administrator at personal appointment, unavailable. LPA Vaid and caregiver Oriemo toured the facility and did not observe any health or safety concerns. LPA collected staff and resident roster. Interviewed staff and residents.

On 02/23/26, LPA Vaid requested and obtained for review the following documents, staff and resident roster, R1's face sheet/ID, physician report, needs and services, medication record and medication administered record, physician orders for medications. Interviewed staff #1-#3. Interviewed clients R#2- and R#3. Unusual Incident report dated 03/01/26.

The investigation revealed the following:
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2026
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 2
Control Number 28-AS-20260223144352
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: A FAITHFUL HOME OF COVINA
FACILITY NUMBER: 198603328
VISIT DATE: 06/16/2026
NARRATIVE
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Allegation: Staff did not seek medical attention for resident. It is alleged that the staff did not seek and provide resident with medical attention when resident requested medical attention. Three of three staff deny this allegation, when residents request medical attention, the staff notifies the residents physician and awaits further orders, the residents is given PRN for pain when needed. Staff stated residents are always transported to the medical facilities when prompted by the residents’ medical authorizations, and/or the state of the Residents health condition during the time of the emergency. Three of four residents stated getting medical attention when they require it, staff call the medical agencies when necessary. Based on interviews and records review, there is no evidence to corroborate this allegation.

Allegation: Staff did not provide adequate supervision to residents in care. It is alleged that the facility is not providing adequate supervision to the residents in care resulting in a resident attempting to attack another
resident, and staff did not act quickly enough to stop the attack. Three of three staff deny this allegation, S1 stated residents are free to roam the facility and visit others residents’ rooms via invitation. Staff stated rushing to R1’s room having heard R1’s request for help, S3 separated R2 from R1’s room and S1 called 911 while R2 administered first aid to the wound site. Staff stated redirecting R2 away from R1 multiple times. R2 stated having attempted to interfere with staff giving 1st Aid to R1. Insisting R2’s past medical training. Three of four residents could not corroborate this allegation. Two of four residents acknowledge paramedics arriving. Based on staff and residents’ interviews, there is no evidence to corroborate this allegation.

Allegation: Staff has inappropriate interaction with resident. It is alleged that the staff are having inappropriate interactions with residents and making disparaging remarks about the residents’ physical condition. Three of three staff denied this allegation, staff stated they are providing residents with comfortable care and assisted living needs and services, Staff stated they treat residents with dignity and respect and words of positive affirmation. Three of four residents could not corroborate this allegation, two of four residents’ stated the staff is respectful and does not have inappropriate interaction with residents. Based on staff and residents’ interviews and observations, there is no evidence to corroborate this allegation.

Although the allegation(s) may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur; therefore, the allegation(s) are unsubstantiated.

Exit interview was conducted with staff, Glen Oriemo.
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Sanjay Vaid
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2