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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603419
Report Date: 11/07/2025
Date Signed: 11/07/2025 03:17:08 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
10/17/2025 and conducted by Evaluator Glenn Trueman
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251017131720
FACILITY NAME:PT MOUNTAIN VIEW HOME INC.FACILITY NUMBER:
198603419
ADMINISTRATOR:TABACHNIKOV, PAULFACILITY TYPE:
735
ADDRESS:23546 SUNSET CROSSING RD.TELEPHONE:
(310) 221-1383
CITY:DIAMOND BARSTATE: CAZIP CODE:
91765
CAPACITY:4CENSUS: 4DATE:
11/07/2025
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Staff S1TIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff hit a client
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Glenn Trueman conducted a subsequent complaint visit regarding the allegation listed above. LPA arrived unannounced and met with Staff S1. The purpose of the visit was explained.
The initial visit was conducted on 10/23/25 and the investigation consisted of the following:
LPA toured the facility and reviewed Client C1’s file and Physician's Report, Individual Program Plan (IPP), Emergency ID Face Sheet, and Special Incident Report (SIR) to be submitted. Law Enforcement Report to be submitted.
Staff S1's file was reviewed.
Interviews were held with the Administrator,(telephonically), Staff S1 (telephonically), Staff S2 at the facility at today's visit and Staff S3 (telephonically).
All 4 clients were at their respective Day Programs.
At today's visit 11/07/25 Client's C1- C2 were interviewed. However Client C3- C4 had limited responses to questioning and would nod yes or no and had 1 word answers such as yes or no.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Glenn Trueman
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025
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-20251017131720
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: PT MOUNTAIN VIEW HOME INC.
FACILITY NUMBER: 198603419
VISIT DATE: 11/07/2025
NARRATIVE
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In regards to the allegation Staff hit a client, based on interviews conducted and information gathered it was revealed by Client C1 who stated that Staff S1 helps her with laundry and cooking. Also said Staff S1 will help her getting ready for showering. Said Staff S1 is cool.
Stated that staff are good and treat her well. Said staff are nice.
Said nothing bad has happened here. When asked if Staff S1 or any staff slapped or hit her she said no.
Client C2 stated that staff are good and help with food, medication and showering.
Stated that staff speak to them nicely.
Said Staff S1 and S2 are helpful.
Stated S1 or any staff has never done anything physical. Said never slapped or hit. When asked if Staff S1 slapped C1 she said never.
Stated that every morning C1 yells at staff.
Client C3 said yes when asked if staff treat her well and when asked if all good here and nothing bad nodded yes.
Client C4 said yes when asked if staff are good here. When asked if any staff slaps or hits she said no.
Interview with Administrator who stated that there has not been any complaints in the past regarding abuse involving staff and a resident. Said that Law Enforcement responded to the allegation and said there was no evidence of abuse.
Interview with Staff S1 who stated that there have been no negative interactions with Client C1.
Said that Client C1 is assisted with incontinence issues and it has always been done appropriately.
Staff S2 stated that Client C1 had told her that S1 slapped her. Staff S1 said she didn't do it. Stated that there were not any staff or client who witnessed abuse having occurred. Spoke with Regional Center and their findings were Unsubstantiated with there being no witnesses to support the allegation having occurred.

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 and a copy of this report was provided.



















San Gabriel/Pomona Regional Center (SG/PRC) in a letter dated 09/23/25 which states that the allegations of physical abuse were Unsubstantiated.
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Glenn Trueman
LICENSING EVALUATOR SIGNATURE:

DATE: 11/07/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2