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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603586
Report Date: 10/16/2025
Date Signed: 10/16/2025 12:33:33 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
10/10/2025 and conducted by Evaluator Christian Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251010112505
FACILITY NAME:HENRIETTA'S LEVEN OAKSFACILITY NUMBER:
198603586
ADMINISTRATOR:STEPHANY PEREZFACILITY TYPE:
740
ADDRESS:120 S. MYRTLE AVENUETELEPHONE:
(213) 478-0800
CITY:MONROVIASTATE: CAZIP CODE:
91016
CAPACITY:80CENSUS: DATE:
10/16/2025
UNANNOUNCEDTIME BEGAN:
09:59 AM
MET WITH:Claudia SanchezTIME COMPLETED:
12:50 PM
ALLEGATION(S):
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Staff do not safe guard resident's personal belongings.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christian Gutierrez conducted an unannounced complaint investigation visit regarding above allegations. LPA met with Administrator Claudia Sanchez and explained the reason for the visit.

The investigation consisted of the following: LPA requested a copy of resident/staff roster, copies of R1’s identification and emergency information, physician’s report (602), inventory list, special incident report (SIR), and appraisal needs and service plan for resident.

SEE LIC 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2025
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 2
Control Number 28-AS-20251010112505
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: HENRIETTA'S LEVEN OAKS
FACILITY NUMBER: 198603586
VISIT DATE: 10/16/2025
NARRATIVE
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In regard to the allegation “Staff do not safeguard resident's personal belongings”. It is alleged that staff went through R1’s personal valuables resulting in R1 having to carry around a satchel. During interviews with Administrator and staff four (4) out of four (4) staff stated that they have never taken a resident belonging or went through their stuff. Administrator stated that R1 was given a lock to place items of value in because he/she stated that electronics had gone missing before. S1 stated that they were told by R1 to go into his/her room to get a can of corn for them and later was accused of going through drawers. During interviews with residents three (3) out of (4) residents stated that they have never had anything missing from their room. R1 stated he/she told S1 to go to their room to get a can of corn at dinner time but later when R1 returned to room drawers looked like someone had gone through them and S1 was the only one who had been in there. R1 stated nothing was missing.

Based on interviews conducted and records reviewed, there is insufficient evidence to support the allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. An exit interview was conducted, and a copy of this report was provided.

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2025
LIC9099 (FAS) - (06/04)
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