<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004207
Report Date: 11/25/2025
Date Signed: 11/25/2025 10:03:02 AM

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
11/18/2025 and conducted by Evaluator Erik Zaragoza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251118123138
FACILITY NAME:MERCEDES DIAZ HOMES INC - DAVENRICHFACILITY NUMBER:
306004207
ADMINISTRATOR:NAYELI NOLASCOFACILITY TYPE:
735
ADDRESS:11102 DAVENRICH RDTELEPHONE:
(562) 863-1932
CITY:SANTA FE SPRINGSSTATE: CAZIP CODE:
90670
CAPACITY:5CENSUS: 5DATE:
11/25/2025
UNANNOUNCEDTIME BEGAN:
09:32 AM
MET WITH:Nayeli Nolasco - Administrator TIME COMPLETED:
10:34 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are physically abusing resident
Staff are verbally abusing resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Erik Zaragoza conducted a subsequent unannounced complaint visit to address the allegations listed above. LPA met with Nayeli Nolasco, administrator for the facility, and explained the purpose of the visit.

The investigation consisted of the following: During the initial visit conducted on 11/24/2025, LPAs Erik Zaragoza and Gabriela Castro interviewed Clients #2 and #3 (C2 and C3), Staff #1 - 4 (S1 - S4), and obtained the IPP, Physician's Report, along with Emergency Department and Urgent Care visit for Client #1 (C1). Since the initial visit LPAs interviewed C1 and Client #5 (C5) and also obtained incident reports related to C1. Client #4 (C4) was hospitalized and unable to be interviewed at the time of the visits.

Due to insufficient information, this requires further investigation. Exit interview held and a copy of the report was provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Erik Zaragoza
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2025
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 2
Control Number 28-AS-20251118123138
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: MERCEDES DIAZ HOMES INC - DAVENRICH
FACILITY NUMBER: 306004207
VISIT DATE: 11/25/2025
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
In regards in the allegation "Staff are physically abusing resident," it was alleged that staff have been abusing C1 and that this can be evidenced by the bruising present on C1's body. During interviews with the clients, none of them corroborated the allegation. C1 denied that they were physically abused by the staff in the home. Another client stated that they have not witnessed any of the clients being physically abused by staff in the home. During interviews with the staff, none of them corroborated the allegation. One staff stated that none of the staff physically abuse any of the clients in the facility. Another staff member explained C1 does exhibit self-injurious behavior, which lead to bruising on C1's body. During record review, LPA reviewed multiple records of C1's urgent care visits to treat their self-injurious behavior.

In regards to the allegation that "Staff are verbally abusing resident," it is alleged that C1 has been verbally abused by staff members in the facility. During interviews with the clients, three (3) out of four (4) did not corroborate the allegation. C1 stated that they have not been verbally abused by any of the staff members in the facility. During interviews with the staff, none of them corroborated the allegation. One staff stated that they never verbally abuse C1 or any of the other clients of the home. Another staff stated that at times they firmly redirect C1, but never in an abusive manner.

Based on statements and interviews conducted with staff, clients, review of client 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 held, and a copy of this report was provided.
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Erik Zaragoza
LICENSING EVALUATOR SIGNATURE:

DATE: 11/25/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2