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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603557
Report Date: 07/21/2025
Date Signed: 07/21/2025 03:04:43 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
07/15/2025 and conducted by Evaluator Kimberly Ramirez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250715215141
FACILITY NAME:PEOPLE'S CARE NOGALFACILITY NUMBER:
198603557
ADMINISTRATOR:JASMIN SMITHFACILITY TYPE:
737
ADDRESS:8716 NOGAL AVENUETELEPHONE:
(909) 287-3557
CITY:WHITTIERSTATE: CAZIP CODE:
90606
CAPACITY:4CENSUS: 3DATE:
07/21/2025
UNANNOUNCEDTIME BEGAN:
08:05 AM
MET WITH:Administrator Jasmin Smith TIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff spoke inappropriately towards a client
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kimberly Ramirez conducted an unannounced initial complaint investigation visit on 07/21/2025 regarding the above allegation. During today’s visit, LPA Ramirez was greeted by Administrator Jasmin Smith and explained the purpose of the visit.

LPA Ramirez requested and obtained copies of Resident/Client Roster (LIC 9020), Personnel Report (LIC 500), copies of Staff#2 (S2): Coaching and Corrective Action (CCA) form dated 6/19/2025, Interview of Staff#1, 4 (S1 & S4), Attempted interview of Client#1 (C1), copies of Client#1 (C1): Emergency Identification contact form, Physician report, Incident Report dated 06/06/2025, Individual Program Plan (IPP) and physical plant tour.

see 9099-C
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Kimberly Ramirez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2025
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 3
Control Number 28-AS-20250715215141
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: 07/21/2025
NARRATIVE
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The investigation revealed the following: regarding the allegation “Staff spoke inappropriately towards a client.” It is alleged staff spoke inappropriately to a client. On 7/21/2025, LPA Ramirez reviewed Incident Report dated 6/6/2025, which revealed that C1 made an inappropriate comment to S2 and S2 repeated the same inappropriate comment back to C1. Interview with S4 revealed that they witnessed S2 speak inappropriately to C1 on 6/6/2025. Interview with S1 corroborated the allegation that staff spoke inappropriately towards a client. S1 revealed on 6/7/2025, S2 was placed on leave and taken off the schedule pending an internal investigation. Review of Coaching and Corrective Action (CCA) form dated 6/19/2025, revealed after an internal investigation conducted by the facility, S2 was terminated as result of the verbal altercation that took place on 6/6/2025, involving C1. Based on interviews and records reviewed, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. LPA Ramirez will issue one (1) Type B deficiency.

Exit interview was conducted. A copy of this report, 9099-D and appeals rights was provided via email.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Kimberly Ramirez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20250715215141
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/21/2025
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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*No further action is required at this time.* On 6/19/2025, staff received re-training on Zero Tolerance & Rights Scenarios/Activities, supervising the residents under our care, resident behaviors and documentation. LPA Ramirez obtained copies of re-training and attendee sign in.
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S2 was heard speaking inappropriately to C1 on 6/6/25. This poses a potential 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.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Kimberly Ramirez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/21/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3