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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603641
Report Date: 09/16/2025
Date Signed: 09/16/2025 05:18:49 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
09/11/2025 and conducted by Evaluator Noemi Galarza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250911210228
FACILITY NAME:MERCEDES DIAZ HOMES, INC - CALMADAFACILITY NUMBER:
198603641
ADMINISTRATOR:COLLAR, NICOLEFACILITY TYPE:
735
ADDRESS:7919 CALMADA AVETELEPHONE:
(562) 945-4576
CITY:WHITTIERSTATE: CAZIP CODE:
90602
CAPACITY:4CENSUS: 4DATE:
09/16/2025
UNANNOUNCEDTIME BEGAN:
03:44 PM
MET WITH:Claudia Lujan, Quality Assurance DirectorTIME COMPLETED:
05:20 PM
ALLEGATION(S):
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Staff do not ensure residents receive therapy sessions.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Galarza conducted an initial 10-day complaint investigation visit regarding the above allegations. LPA discussed the purpose of the visit telephonically with Administrator Crystal Alegre. Quality Assurance Director Claudia Lujan assisted with the visit.

The investigation consisted of: A physical plant tour of the interior and exterior grounds was conducted. taff (S1- S2) were interviewed. Review of client files and Physical Therapy Consultant Sign In Log was completed. Copies of physical therapy invoices, Consumer Profile, Regional Center Corrective Action Plan, and LIC 500 Personnel Report were reviewed and obtained.


*See next page for narrative.






Copies of Physical Therapy Invoices for residents
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2025
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 3
Control Number 28-AS-20250911210228
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: MERCEDES DIAZ HOMES, INC - CALMADA
FACILITY NUMBER: 198603641
VISIT DATE: 09/16/2025
NARRATIVE
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Allegation: Staff do not ensure residents receive therapy sessions. The complaint alleges the facility was out of compliance in providing 7 hours of behavior consultant services for individuals in the home during the months March 2025 - June 2025, and between months October 2024, December 2024, and January 2025. Per record review, it was noted that on February 21, 2025, Regional Center Quality Assurance Specialist documented the concern and made the recommendation that Administrator shall ensure 7 hours of monthly consultant hours are provided to all individuals. However, on August 20, 2025, during the Regional Center annual review it noted that the issue with consultant hours was not fulfilled. The findings indicate the licensee did not provide a minimum of 7 hours a month of consultation hours per individual as noted on the program design and Regional Center contract.

Staff interviews revealed that consultant hours in physical therapy services did not meet the required contracted 1 hour. During several months the physical therapist was short 45 minutes in PT services to individuals, but billed the entire hour. It is unknown if the physical therapist was visiting the facility at times in which the individuals were not present. Staff stated that the program design states 7 hours of consultant services, which includes that a behavior consultant, nurse consultant, and physical therapist shall be provided services for each individual. Staff stated that nurse and behavior consultant hours were not impacted. On September 10, 2025, the Regional Center issued a Corrective Action Plan (CAP) that states the facility was out of compliance and was not providing the agreed upon consultant hours.

Based on record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Pursuant to Title 22, California Code of Regulations, a deficiency was cited.

Exit interview was conducted with Quality Assurance Director Claudia Lujan and a copy of appeal rights and report was issued.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20250911210228
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: MERCEDES DIAZ HOMES, INC - CALMADA
FACILITY NUMBER: 198603641
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/16/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/30/2025
Section Cited
CCR
85022(a)(2)
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Plan of Operation. The plan of operation shall contain written evidence of arrangements for any consultants and community resources which are to be utilized to meet regulatory requirements or requirements of the facility's plan of operation. This requirement was not met evidenced by:
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Administrator arranged make-up hours for the missing physical therapy hours for R1 & R2. The hours have been completed.
Please submit a written plan of correction and proof of correction.
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Based on record review, the findings indicate that physical therapy consultant hours for 2 individuals did not meet the required program design, which states 7 hours of consultant hours shall be provided to each individual. The PT invoiced hours were less than the required per visit. This poses a potential health, safety, and personal risk.
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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.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3