198603727-10-23-2025-28-AS-WSHO-DMURK8-20251027130504

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603727
Report Date: 10/23/2025
Date Signed: 10/23/2025 06:58:10 PM

Unsubstantiated

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
10/14/2025 and conducted by Evaluator Nune Margaryan

COMPLAINT CONTROL NUMBER: 28-AS-20251014113314

FACILITY NAME:	NORWALK VILLAS I		FACILITY NUMBER:	198603727
ADMINISTRATOR:	WOOD, CHERIE		FACILITY TYPE:	740
ADDRESS:	12121 164TH ST		TELEPHONE:	(562) 229-9957
CITY:	NORWALK	STATE: CA	ZIP CODE:	90650
CAPACITY:	6	CENSUS: 6	DATE:	10/23/2025
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Liberty Palcone		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff does not ensure client is spoken to in an appropriate manner.
Staff did not prevent client from threatening other client in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nune Margaryan conducted an unannounced complaint investigation visit regarding the above allegations. LPA Margaryan met with staff Liberty Palcone. Administrator arrived shortly after and assist with the visit. The reason for the visit was explained.

The investigation consisted of the following: LPA Margaryan obtained a copies of the Staff roster, Residents roster, reviewed Client 1 (C1) file and obtained copies of relevant documents. Interviews conducted with Administrator, Staff 1 and Staff 2 (S1 and S2), Client1 to Client 4 (C1 to C4). S1 was interviewed over the phone.

Continue 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025

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-20251014113314

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: NORWALK VILLAS I	FACILITY NUMBER: 198603727
	VISIT DATE: 10/23/2025

NARRATIVE

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The investigation revealed the following: Regarding allegations: Staff does not ensure client is spoken to in an appropriate manner. It was alleged that Staff (name unknown) yelled at the client and called them an “angry person” when client told staff not to interrupt their video that client was filming outside.

Interviewed Administrator and staff denied the allegation. They stated that they do not yell at clients and have not observed that other staff yell at clients. They stated that they didn't call C1 or other clients “angry person”. Interviewed Administrator stated that on 10/14/25 there was an incident that C1 was making a video in front of facility. During one of staff round, responsible for monitoring clients outside the facility, the staff (S1) didn't notice that C1 filming a video and walked into the area where the filming was taking place. C1 started to yell on S1, stating that S1 disrupted the video that C1 was making. Despite S1's apology to C1, continued to verbally confront S1. Upon entering the facility C1 continued to yell at the staff. One of the clients (C2) came out from their room and asked C1 to stop yelling towards the staff. Staff make sure that C2 is safe and back in their room. After a while C1 calmed down and went in their room. Interviewed S1 stated that incident happened between them and C1 on 10/14/25. S1 went outside of the house and didn't know that C1 was filming. S1 steeped out to check on clients who were outside of house. S1 stated that C1 raised their voice and yelled on S1, stating that S1 disturbed C1. S1 said sorry to C1 but C1 didn't stop yelling. C1 continued to yell on S1 after entering the house. Interviewed S2 stated that they heard how C1 was yelling on S1. S2 stated that S1 didn't yelled back and try to calm C1 down. Interviewed staff stated that staff didn't yell and called “angry person” C1 or other clients. Interviewed clients stated that facility staff is nice and treat them with respect. Interviewed C2 and C3 stated that C1 always yelling and always complains about everything and about everyone. C2 stated that about week ago C1 was screaming, yelling and threatening S1. C2 who was sleeping in their room, came out and ask C1 to stop yelling and threatening the staff. Interviewed C1 stated that staff are nice and this place is 100% better comparing with previous facility that they lived before. C1 stated that they feel safe here.

Continue 9099C

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20251014113314

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: NORWALK VILLAS I	FACILITY NUMBER: 198603727
	VISIT DATE: 10/23/2025

NARRATIVE

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Regarding allegation: Staff did not prevent client from threatening other client in care. It was alleged that client (name unknown) threatened C1 by getting in the client’s face and threatening C1 that they will be hurt if “they talk to staff that way”.

Interviewed Administrator and staff stated that no one has threatened C1. They stated it was C1 who was verbally abusive and threatened staff and clients. Administrator and staff stated that on 10/14/25 C1 was yelling and threatening S1. During the round, S1 who was responsible for monitoring residents outside the facility, didn’t notice that C1 filming a video and walked into the area where the filming was taking place. C1 started to yell on S1, stating that S1 disrupted the video that C1 was making. Despite S1's apology to C1, C1 continued to verbally confront S1. Upon entering the facility C1 continued to yell at the staff. One of the clients (C2) came out from their room and asked C1 to stop yelling towards the staff. Staff make sure that C1 and C2 are safe and back in their rooms to avoid any issues. Interviewed S1 and S2 stated that C2 did not threaten C1. C2 just ask C1 to stop yelling and threaten the staff. Interviewed Administrator and staff stated C2 or other clients didn't get on C1's face and threatened C1 to hurt them. Interviewed C2, C3 and C4 stated that they never witnessed staff or clients threatening C1 that they would hurt C1. Interviewed C2 and C3 stated that C1 was threatened S1 about week ago. They stated that C1 was yelling at S1 and when C2 came out from their room and ask to stop, C1 started to yelled on C2 and was threatening C2 that will "break every bone in their body". C2, C3 and C4 indicated that C1 who often screamed, yelled and threatened staff and clients. Interviewed C1 stated that clients didn't threaten to hurt C1 and they are C1's friends and they are nice.

Based on interviews conducted with facility staff, and facility clients, there was not enough supportive evidence to concur with the reported allegations. 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 allegations are Unsubstantiated.

Exit interview conducted and a copy of this report was provided to Administrator.

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2025

LIC9099 (FAS) - (06/04)

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