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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603489
Report Date: 01/15/2026
Date Signed: 01/23/2026 02:47:09 PM

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
01/06/2026 and conducted by Evaluator Gabriela Castro
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260106103917
FACILITY NAME:ABOVE AND BEYOND ADULT RESIDENTIAL FACILITYFACILITY NUMBER:
198603489
ADMINISTRATOR:KIMBERLY ALLENFACILITY TYPE:
735
ADDRESS:430 S. MOUNTAINTELEPHONE:
(951) 323-3852
CITY:CLAREMONTSTATE: CAZIP CODE:
91711
CAPACITY:4CENSUS: 3DATE:
01/15/2026
UNANNOUNCEDTIME BEGAN:
07:35 AM
MET WITH:Kimberly Allen, Administrator TIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Staff member physically abused resident in care.
INVESTIGATION FINDINGS:
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***This is an amended report of the original report dated January 15, 2026. The reason the report is being amended is to remove confidential information and to make a correction on date of incident. Finding remain the same.***


Licensing Program Analyst (LPA) Gabriela Castro conducted an unannounced complaint investigation visit on 01/15/2026 to deliver findings related to the above allegation. Upon arrival, the LPA was greeted by Teri Austin, and the purpose of the visit was explained. Administrator Kimberly Allen arrived shortly thereafter.

On 01/15/2026, the investigation included a review of the client roster, staff roster, resident face sheet, Individual Program Plan (IPP), daily progress notes, and behavioral data frequency logs. There are three residents residing in the home. LPA attempted to interview all residents; however, only R1 was verbal and able to participate in an interview. In addition, the LPA conducted interviews with five staff members (S1–S5) and resident R1.

(continued 9099C)

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Gabriela Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2026
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-20260106103917
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: ABOVE AND BEYOND ADULT RESIDENTIAL FACILITY
FACILITY NUMBER: 198603489
VISIT DATE: 01/15/2026
NARRATIVE
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Allegation: Staff member physically abused resident in care.

The investigation revealed the following:

The complaint alleged that the facility failed to protect a resident from physical abuse when staff allegedly struck a resident on the left eye.



During staff interviews, staff denied witnessing or being aware of any physical altercation involving the resident. Staff reported they did not observe any injuries, bruising, or swelling to the resident’s eye. Staff stated the resident did not report being struck or injured to them during their shifts. Staff further reported they did not hear or observe any disturbances involving the resident and were not aware of any issues related to the resident’s television. S1 was interviewed via cell phone, as staff had been removed from duty. S1 stated the incident occurred on a Saturday 1/3/26 at approximately 10:28 p.m., at the start of their shift. S1 reported entering the bedroom shared by R1 and R2 to check R2’s blood sugar and believed R1 was asleep. S1 stated R1 later turned the television on at a loud volume, causing other residents to become upset. S1 reported asking R1 to lower the volume, but R1 refused and stated, “Don’t touch my property.” S1 admitted to disconnecting the television to reduce the noise and calm other residents. S1 stated R1 said, “I will make sure you don’t have a job by Monday.” S1 denied physically harming or touching R1. During the resident interview, the resident stated that S1 struck them with his right and left fist, causing injury to the resident’s eye. The resident reported the incident occurred at night in their bedroom while watching television and stated that no one witnessed the incident. The resident stated that their eye hurt and asked whether it appeared dark. The resident reported that they feel safe with other staff and stated that they like their home.
During the investigation, the LPA reviewed staff schedules, client and staff rosters, the resident’s face sheet, Individual Program Plan (IPP), daily progress notes, and behavioral data frequency logs. No documentation was found indicating an observed injury to the resident’s eye. Law enforcement responded to the facility on 01/05/2026 and interviewed staff. S1 was removed from duty on 01/05/2026 pending further action. The alleged incident was not witnessed, and there were no documented reports of injury observed by staff.

Based on the investigation conducted, including interviews with staff and resident and review of relevant records, there was insufficient evidence to support the reported allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. Exit interview was held, and a copy of this report was provided.

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Gabriela Castro
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2026
LIC9099 (FAS) - (06/04)
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