198603584-9-2-2025-28-AS-WSHO-DLYNMJ-20250929103512

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603584
Report Date: 09/02/2025
Date Signed: 09/02/2025 12:10:04 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
08/26/2025 and conducted by Evaluator Mayra Cota

COMPLAINT CONTROL NUMBER: 28-AS-20250826100216

FACILITY NAME:	LOS ROBLES GUEST HOME		FACILITY NUMBER:	198603584
ADMINISTRATOR:	AVILA, LEAH		FACILITY TYPE:	735
ADDRESS:	1657 N LOS ROBLES		TELEPHONE:	(626) 797-0808
CITY:	PASADENA	STATE: CA	ZIP CODE:	91104
CAPACITY:	12	CENSUS:	DATE:	09/02/2025
		UNANNOUNCED	TIME BEGAN:	08:31 AM
MET WITH:			TIME COMPLETED:	12:20 PM

ALLEGATION(S):

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Staff does not ensure facilty is free from pests.
Facilty is in disrepair.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Mayra Cota conducted an unannounced 10-day complaint investigation visit regarding the above stated allegations. LPA met with Wendy Avalos, Direct Support Provider, and explained the reason for the visit. Leah Avila, Assistant Administrator and Mark Avila, Owner, arrived thereafter.

The investigation consisted of the following:

LPA conducted a tour of the home including (5) client bedrooms, (3) bathrooms and the common areas of both floors, conducted interviews with Staff 1 – Staff 4 (S1-S4) and Client 1 – Client 5 (C1-C5) and reviewed records during today’s visit.

***Continues on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Mayra Cota
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)

Page: 1 of 3

Control Number 28-AS-20250826100216

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: LOS ROBLES GUEST HOME	FACILITY NUMBER: 198603584
	VISIT DATE: 09/02/2025

NARRATIVE

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The investigation revealed the following:

Regarding: Staff does not ensure the facility is free from pests.

It is alleged that facility has roaches and bugs inside rooms.

Interviews with S1-S4 deny the allegation. Staff interviews indicated that the facility does not have roaches, nor any other sort of pests in client bedrooms or in any other room in the house. Staff also stated they have no concerns regarding roaches or other pests because they have not observed any throughout the facility. S1-S4 indicated, the facility has a contracted pest management vendor who comes out every month to do treatment for prevention inside and outside of the home. Interview with S3 further indicated, if there would be a need for treatment to be conducted in between the monthly scheduled visit from the vendor, S3 will proceed with doing the necessary treatments for pests if they were to be observed. Interviews with C1-C5 indicated they have not observed any roaches or other pests in their rooms or throughout the facility and therefore, they don’t have any concerns regarding pests. A review of facility records indicated that the facility gets a monthly pest control visit from a vendor in which the home is treated for pests, including roaches. During inspection of the facility by LPA, no live or dead pests were observed in (5) client bedrooms, (3) bathrooms, kitchen, storage and pantry, and the common areas of both floors of the facility. LPA also checked concealed areas behind furniture and appliances and were found to be free of pests. Staff and client interviews, record review and LPA observation do not corroborate the allegation.

Regarding: Facility is in disrepair.

It is alleged that the facility has not used the air conditioner during the current heat wave and inside temperature is 90 degrees.

Interviews with S1-S4 deny the allegation. Staff interviews indicated that the facility has not stopped using the air conditioner during the heatwave nor has the facility experienced 90-degree temperature inside client rooms or the common areas of the home. S1-S4 further indicated, the home is equipped with two separate AC units, one for each floor of the house. The first and second floor AC units have not had any malfunctions in the past and have been working properly throughout the heat wave. S1-S4 stated, clients also have ceiling fans and fans on stands which they can use freely at any time. Interview with S2 indicated, the AC’s thermostats can be adjusted by clients and whenever they want to. S1-S4 further stated the clients have not complained about the home being too hot. ****Report continues on LIC 9099-C page 2****

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Mayra Cota
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)

Page: 2 of 3

Control Number 28-AS-20250826100216

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: LOS ROBLES GUEST HOME	FACILITY NUMBER: 198603584
	VISIT DATE: 09/02/2025

NARRATIVE

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Interview with C1-C5 indicated that the AC units on both floors have been working properly. Clients stated the house is cool and comfortable. C1-C5 further stated, the AC units have not malfunctioned, and both units are running properly. LPA observations indicated that the AC units on both floors were running at the time of the visit. Both AC units were tested and were found to be working properly. The thermostat on the first floor registered the room temperature to be 74-degrees F. at the time of LPA inspection. LPA observation found both floors in the home to be at a comfortable temperature and client ceiling and stand fans were operating at the time of visit. Staff and client interviews, and LPA observations do not corroborate the allegation.

Although the allegations may have happened or are valid, there is no preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation are unsubstantiated. An exit interview was conducted Leah Avila, Assistant Administrator, and a copy of this report was provided.

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Mayra Cota
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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