198603557-9-2-2025-28-AS-FFIS-DM3UZB-20251002160115

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603557
Report Date: 09/02/2025
Date Signed: 09/02/2025 03:59:37 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
07/17/2025 and conducted by Evaluator Kimberly Ramirez

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250717105355

FACILITY NAME:	PEOPLE'S CARE NOGAL		FACILITY NUMBER:	198603557
ADMINISTRATOR:	JASMIN SMITH		FACILITY TYPE:	737
ADDRESS:	8716 NOGAL AVENUE		TELEPHONE:	(909) 287-3557
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90606
CAPACITY:	4	CENSUS: 3	DATE:	09/02/2025
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Administrator Jasmin Smith		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff inappropriately pushed a client.
Staff did not prevent a client from sustaining injuries while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced subsequent complaint investigation visit on 09/02/2025 to deliver findings regarding the above allegations. LPA Ramirez conducted a Health & Safety visit on 07/21/2025 and a needs further investigation was documented. During today’s visit, LPA Ramirez was greeted by Lead Registered Behavioral Technician (RBT) David Baeza and explained the purpose of the visit. Administrator Jasmin Smith arrived shortly after and greeted LPA Ramirez.

The investigation consisted of the following: LPA Ramirez requested and obtained copies of Resident/Client Roster, Staff Roster, Staff#1 - 4 interviews (S1 – S4), Client Interviews#1 -3 (C1 – C3), Copies of client#1-3 (C1-C3): Recent Individual Program Plan (IPP), Emergency Identification contact form, Physician report, Incident Reports, Internal Review Summary dated 07/18/2025, and physical plant tour.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Kimberly Ramirez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2025

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-20250717105355

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: PEOPLE'S CARE NOGAL	FACILITY NUMBER: 198603557
	VISIT DATE: 09/02/2025

NARRATIVE

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The investigation revealed the following regarding the allegation: “Staff inappropriately pushed a client.” It is alleged S1 inappropriately pushed C1. Four (4) out of the four (4) staff interviewed denied this allegation. Three (3) out of the three (3) clients interviewed denied this allegation. On 08/07/2025, LPA Ramirez interviewed C1 and C1 revealed that S1 did not inappropriately push them. Review of C1’s IPP revealed C1 has a history of making false allegations. Review of incident reports for C1 did not corroborate this allegation. On 07/15/2025, the facility conducted their own investigation. Review of Internal Review Summary dated 07/18/2025, did not corroborate the 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.

“Staff did not prevent a client from sustaining injuries while in care.” It is alleged that staff did not prevent C1 from sustaining injuries while in care. Four (4) out of the four (4) staff interviewed denied this allegation. Three (3) out of the three (3) clients interviewed denied this allegation. On 08/07/2025, LPA Ramirez interviewed C1 and C1 revealed that although they did sustain an injury, the injury was not caused by staff and C1 was not sure how they sustained their injury. Review of C1’s IPP revealed C1 has a history of self-injurious behaviors. Review of incident reports for C1 did not corroborate this allegation. On 07/15/2025, the facility conducted their own investigation. Review of Internal Review Summary dated 07/18/2025, did not corroborate the 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.

No deficiencies were cited for this complaint investigation. Exit interview was conducted. A copy of this report was provided via email.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Kimberly Ramirez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2025

LIC9099 (FAS) - (06/04)

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