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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603388
Report Date: 07/10/2025
Date Signed: 07/11/2025 01:09:56 PM

Substantiated


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
11/08/2024 and conducted by Evaluator Sanjay Vaid
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20241108110825
FACILITY NAME:WORCHESTER HOMEFACILITY NUMBER:
198603388
ADMINISTRATOR:QUADRI, ABIOLAFACILITY TYPE:
735
ADDRESS:790 WORCHESTER AVETELEPHONE:
(562) 884-4903
CITY:PASADENASTATE: CAZIP CODE:
91104
CAPACITY:4CENSUS: 4DATE:
07/10/2025
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Administrator- Oneisha JamesTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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 Conduct Inimical
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sanjay Vaid made a subsequent visit to the facility to deliver complaint findings. LPA was met by Zerlene Graham and explained the purpose of the visit. LPA toured the facility with Zerlene and did not observe any Health and Safety concerns.

On 11/12/2024, LPA Vaid requested, obtained and reviewed copies of four (4) client files: Emergency Contact Form, Physician Report, Appraisal/Needs and Services Plan and client P&I ledgers. Facility file for previous licensee. Updated copy of Surety Bond which expires on 07/07/2026.

Regarding the allegation of Conduct Inimical. It is alleged that the previous licensee was involved in insurance fraud and identity theft, of which some individuals were disabled.

CONTINUED ON 9099C............




Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025
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 6
Control Number 28-AS-20241108110825
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: WORCHESTER HOME
FACILITY NUMBER: 198603388
VISIT DATE: 07/10/2025
NARRATIVE
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Investigator Bureau (IB) Investigator Dennis Seng conducted the investigation. During the investigation, IB investigator Seng interviewed staff, clients, witnesses, and other collateral agencies in relation to the alleged fraud and identity theft. Interviews with Department of Homeland Security (HSI), Employment Development Department (EDD) and United States Postal Office -Inspector General (USPS-IG) all corroborated each other’s statements. The previous licensee was arrested for Unemployment Insurance and Disability Insurance fraud during the period 2020 through 2024. On 01/02/2025 the previous licensee pleaded guilty to charges of fraudulently using the identities and personal information of other individuals to file Unemployment Insurance (UI) and Disability Insurance (DI) claims through EDD. Three (3) out of four (4) facility staff did not corroborate the allegation, staff stated they were made aware of the previous licensee’s involvement during the execution of the Federal Authority search warrant on the facility. Four (4) out of four (4) clients could not confirm this allegation, the clients were not aware of the previous licensee’s conduct and/or misconduct.

In November 2024, the previous licensee applied for a change of owner to remove the previous licensee from the corporation.

The investigation revealed sufficient evidence to prove that the previous licensee was responsible for Conduct Inimical due to filing fraudulent claims with EDD for unemployment and disability insurance.
Based on records reviewed, evidence collected, and interviews conducted the preponderance of evidence standard has been met, therefore the above allegations are found to be substantiated.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 6
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
11/08/2024 and conducted by Evaluator Sanjay Vaid
COMPLAINT CONTROL NUMBER: 28-AS-20241108110825

FACILITY NAME:WORCHESTER HOMEFACILITY NUMBER:
198603388
ADMINISTRATOR:QUADRI, ABIOLAFACILITY TYPE:
735
ADDRESS:790 WORCHESTER AVETELEPHONE:
(562) 884-4903
CITY:PASADENASTATE: CAZIP CODE:
91104
CAPACITY:4CENSUS: 4DATE:
07/10/2025
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Administrator-Oneisha James TIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Licensee financially abused clients in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sanjay Vaid made a subsequent visit to the facility to deliver complaint findings. LPA was met by Zerlene Graham and explained the purpose of the visit. LPA toured the facility with Zerlene and did not observe any Health and Safety concerns.

On 11/12/2024, LPA Vaid requested, obtained and reviewed copies of four (4) client files: Emergency Contact Form, Physician Report, Appraisal/Needs and Services Plan and client P&I ledgers. Facility file for licensee Abiola Quadri. Updated copy of Surety Bond which expires on 07/07/2026.

Regarding the allegation: Licensee financially abused clients in care. It is alleged that the licensee is financially abusing clients in care, by using facility client’s names to file fraudulent Unemployment Insurance (UI)and Disability Insurance (DI) claims made through the Employment Development Department (EDD).

CONTINUED ON 9099C............................
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 28-AS-20241108110825
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: WORCHESTER HOME
FACILITY NUMBER: 198603388
VISIT DATE: 07/10/2025
NARRATIVE
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Investigator Bureau (IB) Investigator Dennis Seng conducted the investigation. Four (4) out of four (4) clients interviewed could not corroborate the allegation and client were not aware of staff financially abusing clients in care. Three (3) out of Four (4) staff interviewed were not able to confirm the allegation. Staff stated they were unaware if the previous licensee stole the identities of any past and/or present clients who resided in the facility. According to IB investigator Seng, review of the client rosters in comparison to the list of UI and DI claims that were fraudulently filed through EDD by the licensee, did not list any of the names of the facility clients. Based upon record review and interviews conducted the findings indicate that, 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 is unsubstantiated.

Exit Interview conducted with Administrator Zerlene Graham.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/17/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 28-AS-20241108110825
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: WORCHESTER HOME
FACILITY NUMBER: 198603388
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/10/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/08/2024
Section Cited
CCR
80046(a)(1)(2)
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Conduct Inimical 80046(a)(1)(a)(2) (a) The department may prohibit any person from being a member of the board of directors, an executive director, or an officer of a licensee, or a licensee from employing, or continuing the employment of, or allowing in a licensed facility, or allowing contact with clients of a licensed facility by, any employee, prospective employee, or person who is not a client who has:(1) Violated, or aided or permitted the violation by any other person of, any provisions of this chapter or of any rules or regulations promulgated under this chapter.(2) Engaged in conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility.
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Administrator will provide in-staff training on clients personal rights an submit proof to Department by 07/18/2025.
Administrator completed staff in-service training client rights on 5/27/25.
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This requirement was not met by the licensee who committed disability and Insurance fraud.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/09/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 28-AS-20241108110825
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: WORCHESTER HOME
FACILITY NUMBER: 198603388
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/10/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/08/2024
Section Cited
CCR
80012(a)
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80012(a) No licensee, officer, or employee of a licensee shall make or disseminate any false or misleading statement regarding the facility or any of the services provided by the facility.
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Administrator will provide in-staff training on clients rights an submit proof to Department by 07/18/2025.
Administrator completed staff in-service training client rights on 5/27/25.
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This requirement was not met by the staff person made false claims of services rendered to clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Sanjay Vaid
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 6