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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603557
Report Date: 03/24/2026
Date Signed: 03/24/2026 03:12:57 PM

Document Has Been Signed on 03/24/2026 03:12 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		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 NOGALFACILITY NUMBER:
198603557
ADMINISTRATOR/
DIRECTOR:		JASMIN SMITHFACILITY TYPE:
737
ADDRESS:8716 NOGAL AVENUETELEPHONE:
(909) 287-3557
CITY:WHITTIERSTATE: CAZIP CODE:
90606
CAPACITY: 4CENSUS: 3DATE:
03/24/2026
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:07 AM
MET WITH:Administrator Lladira Perez TIME VISIT/
INSPECTION COMPLETED:
01:00 PM
NARRATIVE
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Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced Case Management Visit-Incident on 03/24/2026. LPA was greeted by Administrator Lladira Perez and explained the purpose of the visit.

Case Management findings:

On 12/19/2025, LPA Ramirez received a General Event Report (GER) and blank Report of Suspected Dependent Adult/Elder Abuse (SOC 341) for client#1 (C1). According to this report, on 12/17/2025, at approximately 2:15 pm, AM and PM staff were in the living room. Before shift change C1 had clothes in the washing machine and clothing in the dryer and was waiting for their laundry to be done. S1 entered the kitchen area asking about the popsicles that they left in the freezer. S1 asked who ate a popsicle because S1 had three but now there were only two popsicles left. C1 ate a popsicle. S2 then stated “of course C1 ate it because C1 big size. C1 is extra large. S1, S2 and S3 laughed out loud. After staff were done laughing, S2 pointed at C1’s pants and said, ugh you pissed your pants, pee pee pants. C1 started pulling their shirt down and became defensive and explained that their clothes were still in the dryer. On 12/19/2025, S2 was relocated to another home pending an internal investigation.

On 12/31/2025, the facility completed an internal investigation which revealed the following: On 12/18/2025, S4 contacted the facility Human Resources Director to report two incidents involving the safety and well-being of C1 and C2. Both incidents occurred on 12/17/2025. S4 reported that they personally witnessed S2 use bullying and demeaning language towards C1 after C1 urinated on themself. S4 stated that S2 mocked and belittled C1 by referring to C1 as pee pee pants and openly questioning why C1 pissed themselves. S4 also reported that S2 made remarks about C1 weight and size after S2 was unable to locate their popsicle.

SEE 809-C

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Kimberly Ramirez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/24/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 03/24/2026
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S4 also reported an allegation made to S4 by C2. S4 stated that C2 reported being yelled at and threatened with physical harm by S2 during PM shift on 12/17/2025. S4 reported that C2 expressed feeling unsafe around S2. Internal interviews revealed that S4, S5 and S6 heard S1, S2 and S3 laughing at comments made towards C1 weight and size by S2. S4 and S6 corroborated they heard S2 make comments about C1 urinating in their pants and mocking C1. S5 did not corroborate they heard S2 making fun of C1 urinating in their pants but revealed that S2 demeanor was belittling and aggressive in tone and generally unkind. C1 corroborated that S2 made comments about their pants and that S1 and S2 asked C1 why C1 pee pee themselves? C1 revealed they did not feel the comments were meant to be mean. C1 revealed that after the comments were made, C1 changed their clothes. C1 stated they understood the comments were not nice but did not view the situation as a significant issue. C2 revealed that S2 threatened C2 on 12/17/2025 during the PM shift. C2 revealed that no one else witnessed the threat. C2 revealed that S2 threatened to physically hit C2 because C2 got too close to S2, On 12/31/2025, the facility concluded that based on staff and resident interviews, S2 engaged in verbal abuse towards C1. Based on staff and resident interviews, that facility could not determine if S2 engaged verbal abuse towards C2. As a result of this internal investigation, S2 was terminated from the facility on 01/07/2026. On 01/16/2026, S1 was issued a final Coaching and Corrective Action form by the facility for failing to redirect other staff's inappropriate language towards residents. .

On 03/24/2026, LPA Ramirez conducted a facility tour and conducted resident and staff interviews. Based on resident interviews and staff interviews, S1, S2 and S3's conduct violated C1's personal rights and did not treat C1 with dignity. One (1) Type A deficiency is being issued and civil penalties in the amount of $250.00 is being assessed due to a repeat violation of regulation 80072(a)(1). Exit interview was conducted and a copy of this report, 809-D, LIC 421FC and appeals rights was provided.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Kimberly Ramirez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2026
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 03/24/2026 03:12 PM - It Cannot Be Edited


Created By: Kimberly Ramirez On 03/24/2026 at 09:44 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: PEOPLE'S CARE NOGAL
FACILITY NUMBER: 198603557

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/24/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/25/2026
Section Cited
CCR
80072(a)(1)

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(a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following:(1) To be accorded dignity in his/her personal relationships with staff and other persons.This requirement was not met as evidenced by:
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Licensee will draft plan on how the facility will ensure all staff will remain in compliance with 80072(a)(1). Plan must be received by 03/25/2026 via email to LPA Ramirez
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Staff interviews & client interview corroborated S2 verbally abused C1 on 12/17/25. S1 and S3 did not treat C1 with dignity by laughing at the verbally abusive comments S2 made towards C1. This poses an immediate risk to the health, safety, or personal rights of persons 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.
Fernando Fierros
NAME OF LICENSING PROGRAM MANAGER:
Kimberly Ramirez
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 03/24/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/24/2026


LIC809 (FAS) - (06/04)
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