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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 347004385
Report Date: 05/28/2025
Date Signed: 05/28/2025 12:54:07 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/13/2024 and conducted by Evaluator Talwinder Bains
COMPLAINT CONTROL NUMBER: 59-AS-20241113081512
FACILITY NAME:LARCHMONT MANORFACILITY NUMBER:
347004385
ADMINISTRATOR:MARIA YELDONFACILITY TYPE:
735
ADDRESS:7336 LARCHMONT DR.TELEPHONE:
(916) 993-6389
CITY:NORTH HIGHLANDSSTATE: CAZIP CODE:
95660
CAPACITY:6CENSUS: 4DATE:
05/28/2025
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Administrator, Maria YeldonTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff sexually assaulted resident.
INVESTIGATION FINDINGS:
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On 05/28/25, Licensing Program Analysts (LPAs) Talwinder Bains and Lavinia Muscan arrived at the facility unannounced to deliver complaint findings into the allegations listed above and met with Administrator, Maria Yeldon and explained the purpose of today's visit.

During the investigation, the Department conducted interviews and reviewed documentation pertinent to the investigation.

The results of the investigation are as follows:

**Report continued on 9099-C**
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2025
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 3
Control Number 59-AS-20241113081512
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: LARCHMONT MANOR
FACILITY NUMBER: 347004385
VISIT DATE: 05/28/2025
NARRATIVE
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***Report continued from 9099....

Allegation: Staff sexually assaulted resident. Substantiated

The department conducted record review, and staff and resident interviews to investigate this allegation. Resident (R1) was consistent in their disclosure in multiple interviews, including a forensic interview. R1 disclosed that staff (S1) removed their clothing and touched their private parts more than one time. The incident occurred inside R1’s bedroom in the facility. Multiple witnesses reported R1 does not have a history of lying or making up allegations. R1 has not made an allegation of this nature in the past. S1 denied the allegation they sexually assaulted R1. CCHP conducted a forensic psychological evaluation on R1. Forensic interview has determined that based on R1’s cognitive ability to narrate their experiences clearly and consistently highlights their “sincerity” and “credibility.” R1 demonstrates a cognitive profile that suggests resilience against being coached or manipulated in reporting their sexual assault. Additionally, R1’s impaired memory would make it challenging for them to retain and accurately recall a complex and fabricated story. Based on gathered information, this allegation was found to be Substantiated.

Based on interviews conducted by the department and records reviewed, the preponderance of evidence standards has been met. Therefore, the above allegation is found to be SUBSTANTIATED. Please see LIC9099-D for deficiencies cited today per Title 22 Regulations. Civil penalties shall be assessed if facility does not comply with POC requirements which were issued today.


In addition, civil penalties in the amount of $500.00 are assessed today.

Exit interview conducted. Appeal Rights provided. A copy of the report was issued.







SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 59-AS-20241113081512
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO NORTH ASC, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: LARCHMONT MANOR
FACILITY NUMBER: 347004385
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/29/2025
Section Cited
CCR
80072(a)(3)
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80072-Personal Rights- (a)- Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following:(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse......
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Licensee/Administrator shall send a letter of understanding of this regulation and shall conduct staff training.
All POC documents are due by 05/29/25.
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This requirement is not met as evidenced by; record review and interviews reflected that staff ,S1 sexually assaulted resident, R1 at facility which poses a immediate health and safety risks to residents in care.
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Civil penalties in the amount of $500.00 are assessed today.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Laura Munoz
LICENSING EVALUATOR NAME: Talwinder Bains
LICENSING EVALUATOR SIGNATURE:

DATE: 05/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/28/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3