198603722-4-13-2026-28-AS-FFIS-DVMPQP-20260703113127

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603722
Report Date: 04/13/2026
Date Signed: 04/13/2026 04:41:40 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
04/09/2026 and conducted by Evaluator Elena Mallett

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20260409161222

FACILITY NAME:	CRISJADE HOME, LLC		FACILITY NUMBER:	198603722
ADMINISTRATOR:	LOSOYA, MARTHA		FACILITY TYPE:	735
ADDRESS:	14736 FIGUERAS RD		TELEPHONE:	(657) 239-0013
CITY:	LA MIRADA	STATE: CA	ZIP CODE:	90638
CAPACITY:	4	CENSUS: 2	DATE:	04/13/2026
		UNANNOUNCED	TIME BEGAN:	08:04 AM
MET WITH:	Licensee Loida Samonte		TIME COMPLETED:	04:35 PM

ALLEGATION(S):

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Staff hit resident/s

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Elena Mallett conducted an initial unannounced Complaint visit and met with Staff Lydia. LPA discussed the reason for the visit which was to investigate the allegation listed above.Licensee Loida Samonte joined the visit shortly after.

The investigation consisted of the following: On today’s visit, LPA Mallett obtained the current client and staff roster and toured the physical plant and did not observe any health and safety concerns. LPA obtained C1’s and C'2s, Face sheets and physician’s report, C1's IPP , C2's Progress Report from Behaviorist, Initial Personal Rights Training for Staff (S1-S4),CPI cards for (S1-S4) Interviews were conducted with two clients in care and with the Licensee,Administrator,House Manager and all caregivers.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Elena Mallett
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2026

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-20260409161222

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: CRISJADE HOME, LLC	FACILITY NUMBER: 198603722
	VISIT DATE: 04/13/2026

NARRATIVE

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Allegation: Staff hit residents. It has been alleged that staff hit residents.

It is alleged that staff hit a resident during an 04/07/26 incident reported to Licensing. S2 was assisting C1with a glucose reading and an interaction ensued when C1 became upset. S2 states C1 was never kicked or hit. S2's legs were outstretched and C1 did lean in towards S2's legs but S2's legs were not moving,and not in a kicking motion.C1 declined to be interviewed by LPA at this time.C1's family member was interviewed.Licensee states S2 did not kick C1. Licensee called police to the 04/07/26 incident to initiate a 51/50 hold for C1 but police declined to do so. Regional Center has not been out to investigate the 04/07/26 incident.

It is also alleged staff hit a resident with a shoe and cane. Two out two clients in care interviewed deny that staff hit residents with a shoe, cane, hand or foot. Five(5) out of Five(5) staff /Licensee interviews reveal that residents are not hit by staff/Licensee with a cane, shoe, foot or hand. All Staff/Licensee interviews indicated that they have not witnessed any staff/Licensee hitting residents with a cane,shoe, foot or hand. No cane was observed in the facility and zero(0) out of five (5) staff report using/having a cane.

Staff/Licensee interviews and record reviews revealed that all staff are DSP (Direct Support Providers) 2's that have received Personal Rights training as part of DSP training. In-service training on client Personal Rights was conducted by facility in March 2026. All staff had current CPI( Crisis prevention Intervention)training.

The investigation did not reveal a preponderance of evidence to corroborate the allegation.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

LPA Mallett conducted an exit it interview with Licensee Loida Samonte and a copy of this Licensing report was provided.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Elena Mallett
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2026

LIC9099 (FAS) - (06/04)

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