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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 366423836
Report Date: 03/24/2026
Date Signed: 03/24/2026 10:23:14 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/19/2026 and conducted by Evaluator Javier Prieto
PUBLIC
COMPLAINT CONTROL NUMBER: 56-AS-20260319090544
FACILITY NAME:LACEY MANORFACILITY NUMBER:
366423836
ADMINISTRATOR:WESTLING, TANNAFACILITY TYPE:
735
ADDRESS:6564 LACEY ST.TELEPHONE:
(909) 628-5826
CITY:CHINOSTATE: CAZIP CODE:
91710
CAPACITY:4CENSUS: 3DATE:
03/24/2026
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Administrator Tanna WestlingTIME COMPLETED:
10:25 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff yell at resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a complaint investigation regarding the above allegation. LPA Prieto met with Administrator Westling and explained the elements of the complaint.

Allegation #1 - LPA interviewed Administrator Westling (S1) who states that resident #1 (R1) was reminded that a loud conversation had by R1 had to be lowered due to the house rules stating the residents should not infringe upon the rights of others in the household. R1 was not available for interview, as R1 was a respite resident and has not returned to the home. LPA could not corroborate the allegations made in this complaint. Therefore the allegation is unsubstantiated.

Based on the information obtained there is not enough evidence to support the allegations made in this complaint. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. This report was signed by LPA Prieto and Administrator Westling and a copy was left with the home.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 03/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2026
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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