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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005908
Report Date: 07/30/2024
Date Signed: 07/30/2024 04:17:15 PM

Unfounded


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/24/2024 and conducted by Evaluator Jerome Haley
COMPLAINT CONTROL NUMBER: 22-AS-20240724082752
FACILITY NAME:WESTMONT OF CYPRESSFACILITY NUMBER:
306005908
ADMINISTRATOR:PATRICK FRAZIERFACILITY TYPE:
740
ADDRESS:4889 & 4775 KATELLA AVE.TELEPHONE:
(858) 729-6720
CITY:LOS ALAMITOSSTATE: CAZIP CODE:
90720
CAPACITY:152CENSUS: 130DATE:
07/30/2024
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Nancy Rodriguez TIME COMPLETED:
04:25 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff is not meeting the need of the resident
Staff do not answer resident calls for assistance timely
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Regarding the allegation: Staff is not meeting the need of the resident.

12 of 12 individuals interviewed including facility residents and staff were unable to corroborate the allegation above. All 7 residents interviewed denied the allegation. When residents were asked if staff assist them when needed, Resident 5 (R5) said, yes, but I don’t call. We all need assistance here… before adding, staff do a good job. Resident 7 (R7) was asked about receiving assistance from staff, and said, I’m what they call independent. I don’t have one of those (referring to a call button). When Resident 6 (R6) was asked the same question about receiveing assistance from the staff, R6 stated, they always have.

Regarding the allegation: Staff do not answer resident calls for assistance timely.

Continued on LIC9099C
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024
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 22-AS-20240724082752
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: WESTMONT OF CYPRESS
FACILITY NUMBER: 306005908
VISIT DATE: 07/30/2024
NARRATIVE
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32
12 of 12 individuals interviewed including facility residents and staff were unable to corroborate the allegation above. All 7 residents interviewed denied the allegation. When Resident 3 (R3) was asked about staff responding to request for assistance, R3 held up a call button and said, yes, all the time. Resident 2 (R2) was asked the same question and the R2 said, yes... very quickly.

Based on the information gathered through interviews the following allegations: Staff is not meeting the need of the resident and Staff do not answer resident calls for assistance timely, are deemed unfounded, meaning the allegations are false, could not have happened and/or is without a reasonable basis.

An exit interview was conducted, and a copy of this report was provided.
SUPERVISORS NAME: Lourdes Montoya
LICENSING EVALUATOR NAME: Jerome Haley
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2