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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880556
Report Date: 04/30/2025
Date Signed: 04/30/2025 04:28:29 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/05/2024 and conducted by Evaluator Janette Romero
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240205181414
FACILITY NAME:E.X.C.E.L HOUSE, THEFACILITY NUMBER:
331880556
ADMINISTRATOR:STOKES, LATASHAFACILITY TYPE:
735
ADDRESS:24051 MARIE STREETTELEPHONE:
(626) 658-1227
CITY:PERRISSTATE: CAZIP CODE:
92570
CAPACITY:4CENSUS: 4DATE:
04/30/2025
UNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Caregiver, Sparkles FordTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Adult in the home is verbally abusive toward the residents in care
Resident in the home is not provided a safe environment while in care
Adult in the home does not accord a resident privacy while in the restroom
INVESTIGATION FINDINGS:
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On 4/30/2025, Licensing Program Analyst (LPA) Janette Romero conducted an unannounced visit to deliver findings regarding the above allegations. LPA met with
Caregiver, Sparkles Ford who was informed of the purpose of the visit.

Regarding the allegation, “Adult in the home is verbally abusive toward the residents in care” it was alleged Administrator, Latasha Stokes’ husband, Glen Walls, is verbally abusive towards Client 1 (C1). Three (3) of four (4) clients, including C1, were interviewed and reported Mr. Walls has never been verbally abusive towards any of the clients in care. Three (3) staff were interviewed and reported they have never witnessed Mr. Walls or facility staff be verbally abusive with any of the clients in the home. Mr. Walls was interviewed and reported he visits the facility approximately two-to-three times per week to assist with the facility’s maintenance and errands. Mr. Walls reported he has never been verbally/physically abusive with any of the clients in care and has good rapport with all the clients including C1. Regarding the allegation, “Resident in the home is not provided a safe environment while in care” it was alleged Mr. Walls smokes marijuana and drinks until he passes out.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
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 18-AS-20240205181414
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: E.X.C.E.L HOUSE, THE
FACILITY NUMBER: 331880556
VISIT DATE: 04/30/2025
NARRATIVE
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Three (3) of four (4) clients were interviewed and reported they have never witnessed Mr. Walls or anyone in the home smoke marijuana in the facility or drink alcohol until they pass out. Three (3) staff were interviewed and reported they have never smoked marijuana and/or drank alcohol in the facility, nor have they observed other staff do so. Three (3) staff interviewed reported they have never fainted/passed out or witnessed or have knowledge other staff have fainted in the facility. Mr. Walls was interviewed and reported they do not smoke marijuana, and he has never consumed alcohol in the facility. Mr. Walls added they have never suffered a medical emergency in the facility that has resulted in them fainting/passing out.

Regarding the allegation, “Adult in the home does not accord a resident privacy while in the restroom” it was alleged Mr. Walls opens the restroom door when C1 is using the restroom. Three (3) of four (4) clients, including C1, were interviewed and reported Mr. Walls/facility staff have never opened the restroom door while in use. Mr. Walls was interviewed and reported they have never maliciously opened the restroom door while the clients are in there. Mr. Walls explained C1 has a history of self-injurious behaviors including swallowing items such as toothbrushes, screws, nails, and anything within reach resulting in C1 requiring immediate medical treatment. Mr. Walls reported the facility takes preventative measures to secure any items that may be potentially dangerous for C1 and within reach, but C1 has snuck items into the facility and swallowed them. Mr. Walls was unable to recall ever opening the restroom door while C1 was using restroom but reported he would only open C1’s restroom door if there was a serious health or safety concern for C1’s life due to their self-injurious behaviors. Mr. Walls reported he was unable to recall if he may have accidentally opened the restroom door when a client was present and there was no indication the restroom was occupied such as having the restroom light on or door locked.

LPA reviewed C1’s Physician’s Report dated 1/28/2023 indicating C1 is ambulatory and has the capacity to communicate, follow instructions, bathe, dress, feed themselves, and care for their own toileting needs. C1’s Physician’s Report also indicates C1 does not have the capacity to store their own medications, leave the facility unassisted, or manage their own cash resources. LPA reviewed C1’s Individual Program Plan (IPP) dated 11/30/2022 noting C1 has a long of history violent and suicidal behavior. C1’s IPP also notes C1 has a history of swallowing a regular sized toothbrush, silicone packet, and batteries.

During an interview, C1 reported the allegations had been fabricated. Additionally, one (1) of four (4) clients residing in the home refused to be interviewed. Although the allegations may have happened or are valid, there is no preponderance of evidence to prove the alleged violations did or did not occur; therefore, the allegations are unsubstantiated. An exit interview was conducted, and a copy of this report and Confidential Names list (LIC 811) was reviewed over the phone with Administrator Stokes and provided to Caregiver Ford.

SUPERVISORS NAME: Anthony Perez
LICENSING EVALUATOR NAME: Janette Romero
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2