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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603722
Report Date: 06/29/2026
Date Signed: 06/29/2026 08:34:09 AM

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, LLCFACILITY NUMBER:
198603722
ADMINISTRATOR:LOSOYA, MARTHAFACILITY TYPE:
735
ADDRESS:14736 FIGUERAS RDTELEPHONE:
(657) 239-0013
CITY:LA MIRADASTATE: CAZIP CODE:
90638
CAPACITY:4CENSUS: 3DATE:
06/29/2026
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:House Manager- Evelyne LacuestaTIME COMPLETED:
08:30 AM
ALLEGATION(S):
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Staff hit resident/s
INVESTIGATION FINDINGS:
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***This licensing report supersedes the licensing report delivered on 04/13/2026. The reason for the superseded report is to clarify language in Licensing Report. The investigation findings will remain the same. ***
Licensing Program Analyst (LPA) Elena Mallett conducted a subsequent unannounced visit to clarify language on a previous complaint investigation report for the allegation listed above. LPA met with House Manager Evelyne Lacuesta and explained the reason for today’s visit. Licensee Loida Samonte was contacted by House Manager Evelyne Lacuesta and Licensee authorized House Manager to sign superseded Licensing Report.

On 06/29/2026, a staff and client roster was obtained. LPA observed clients in the living room relaxing. LPA toured common facility areas and observed no immediate health and safety risks.

Continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Elena Mallett
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2026
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: 06/29/2026
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 incident that occurred at the facility on 04/07/26. It is also alleged that staff hit a resident with a shoe and/or a cane. Interviews with two (2) out two (2) clients in care revealed that both clients deny that staff hit residents with a shoe, cane, hand or foot. Interviews with five (5) out of five (5) staff, including licensee revealed that clients are not hit by staff and/or the licensee. Staff do not hit clients with a cane, shoe, foot or hand. All staff/licensee interviewed indicated that they have not witnessed any staff and/ or the licensee hitting residents with a cane, shoe, foot or hand. Five (5) staff reported that no clients or staff are using or have a cane. Five (5) staff revealed that all staff have completed personal rights training as part of the Direct Support Providers’ training. During visit, LPA did not observe a cane in the facility. Review of Staff Records revealed that all staff are certified as Direct Support Providers (DSP2) and all staff have received Personal Rights training. In-service training on client Personal Rights was conducted by facility in March 2026. All staff had current CPI( Crisis prevention Intervention) training.

Regarding the 04/07/26 incident between client #1 (C1) and staff #2 (S2). The facility reported the 04/07/26 incident to the department. On 04/07/26, S2 was assisting C1with a glucose reading, when C1 became upset. S2 reported that S2 did not kick or hit C1 during the incident. S2 stated that while S2 was seated in chair at the kitchen table with S2’s legs outstretched, S2 stated that C1 leaned in towards S2's legs. S2 stated that S2 did not move S2’s legs and S2 did not use a kicking motion. The licensee stated that S2 did not kick C1, however, Licensee was not present during the 04/07/26 incident between C1 & S2. Licensee came to the facility after the 04/07/26 incident occurred and licensee called local law enforcement (Norwalk Sherrif) to initiate a 51/50 hold for C1. Norwalk Sherrif declined to place C1 on a 51/50 Hold due to C1 not meeting criteria for a 51/50. Licensee reported the 04/07/26 incident to C1’s Regional Center. During the investigation, C1 declined to be interviewed by LPA, however C1's family member was interviewed.

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 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: 06/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2026
LIC9099 (FAS) - (06/04)
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