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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603586
Report Date: 04/29/2025
Date Signed: 04/29/2025 02:17:49 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
04/21/2025 and conducted by Evaluator Bennette Pena
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250421082118
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: 46DATE:
04/29/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Claudia Sanchez - Interim AdministratorTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff threw away residents personal belongings.
Staff are not treating resident with respect.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced 10-day complaint visit for the above-mentioned allegations. LPA met with Claudia Sanchez, Interim Administrator and explained the purpose of the visit.

The investigation consisted of the following: LPA obtained copies of the Resident & Staff Rosters, Staff in-service training about Safeguarding Personal belongings, Personal Rights, Residents Rights and Zero Tolerance Policy and House rules. LPA also obtained copies of Resident #1 (R1) files such as Face Sheet, Physician's Report (02/26/2024), Admission Agreement, Appraisal/Needs and Services Plan (11/25/2024) and Daily log (Nov. 2024). R1 opted out on completing a list of Property and Valuables. At 11am, LPA conducted a tour of the physical plant with focus on R1’s room. LPA also interviewed Administrator, Staff #1 (S1) - Staff #4 (S4), Resident #1 (R1) – Resident #7 (R7) and telephonically interviewed Witness #1 (W1).
***CONTINUED ON LIC9099-C***
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Bennette Pena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2025
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-20250421082118
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: HENRIETTA'S LEVEN OAKS
FACILITY NUMBER: 198603586
VISIT DATE: 04/29/2025
NARRATIVE
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Allegation: “Staff threw away resident’s personal belongings.” It is alleged that on 11/28/2024, R1 moved in from a different facility and that staff discarded R1’s belongings, including important documents, due to claims of rat droppings. Interviews conducted with the Administrator and (4) staff members denied the allegation. All staff stated that they would never throw away any residents personal belongings without the residents' permission. Staff interviewed also stated that in-service training regarding Safeguarding Personal belongings, Personal Rights, Residents Rights and Zero Tolerance Policy are being conducted to staff members regularly. All staff interviewed stated that there have been no complaints about the disposal of personal belongings have been reported by residents. . Administrator stated that when R1 moved in on 11/28/2024, R1 had many personal items and was asked to consolidate her items due to insufficient space in her room. Administrator stated that R1 sorted out the belongings in the presence of (2) Social workers and another staff member. Administrator stated that R1 gave her consent to discard some items, which W1 confirmed. W1 also indicated that R1 was prepped about the need to downsize before her move to the facility. A total of (7) residents were interviewed, (6) out of (7) residents interviewed indicated that they do not have any issues with their personal belongings being thrown away by staff members. (6) interviewed residents indicated that the facility staff respect their belongings and have never disposed of any of their belongings. Therefore there was insufficient evidence to corroborate with this allegation.

Allegation: “Staff are not treating resident with respect.” It is alleged that R1 feels discriminated against by a staff member and continues to feel " uncomfortable and unsafe" at facility and suffers mental distress. Administrator and (4) staff members interviewed stated that they have never heard of or witnessed any staff discriminate against or treat residents unfairly. Administrator mentioned that the facility has a zero tolerance policy regarding such behavior and that personal rights training is being regularly conducted for staff members. Administrator stated that R1 never expressed any issues to her when she interacts with R1. (4) of (4) staff members interviewed stated that they treat residents with dignity and respect. (6) out of (7) residents that were interviewed indicated that staff members treated them with dignity and respect. (6) residents stated that they have good relationships with staff members here and they feel safe and comfortable. Therefore, there was not enough supportive evidence to corroborate the allegation.

Based on statements and interviews conducted with staff, residents, review of resident files and facility file records, there was not enough supportive evidence to concur with the reported 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.

Exit interview conducted and a copy of this report was provided to Claudia Sanchez, Interim Administrator.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Bennette Pena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 04/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2025
LIC9099 (FAS) - (06/04)
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