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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 405800830
Report Date: 12/19/2025
Date Signed: 12/19/2025 03:32:47 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/17/2025 and conducted by Evaluator Rachael De Leon
COMPLAINT CONTROL NUMBER: 29-AS-20250617163714
FACILITY NAME:AMERICAN CARE HOMEFACILITY NUMBER:
405800830
ADMINISTRATOR:LIXIA ZHANGFACILITY TYPE:
735
ADDRESS:1240 EL CAMINO REALTELEPHONE:
(805) 466-9029
CITY:ATASCADEROSTATE: CAZIP CODE:
93422
CAPACITY:38CENSUS: DATE:
12/19/2025
UNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Maria Lopez, ManagerTIME COMPLETED:
03:35 PM
ALLEGATION(S):
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Staff spoke to residents in an inappropriate manner.
INVESTIGATION FINDINGS:
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Licensing Program Anlayst (LPA) De Leon conducted a subsequent complaint visit to the facility above. LPA met with Maria Lopez, back up to Administrator and explained the purpose of the visit.

LPA De Leon conducted the initial 10 day complaint visit on 06/18/2025 requested records and interviewed staff at 3:30pm and 3:45pm.

LPA interviewed residents at 2:46pm, 2:50pm, 2:55pm, 3:00pm, and 3:10pm.

On the allegation: Staff spoke to residents in an inappropriate manner. LPA De Leon interviewed staff which revealed the staff do not talk inappritoritely to residents in care, No one yells or cusses at the reisdents in care. Staff do talk to residents when something is wrong but always respectfully. Staff try to help residents when they need something.
Continued 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2025
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 29-AS-20250617163714
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: AMERICAN CARE HOME
FACILITY NUMBER: 405800830
VISIT DATE: 12/19/2025
NARRATIVE
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 LPA interviewed 5 residents and 4/5 residents interviews revealed the staff are good, they never yell at the residents, the staff do a good job, never heard the staff yell or cuss at any residents in care, 1/5 residents stated sometimes the neighbors complain about us as the neighbors are new to the neighborhood and are not sure what the facility is and do not understand some of the residents have issues with mental health or physical needs, the staff have to talk to us when neighbors complain but just to avoid further issues not to talk inappropriately to residents in any way. 1/5 resident stated the staff refuse to give resident meals and medications but could not tell LPA when or who the staff are that this happens with. Based on the lack of evidence this allegation is Unsubstantiated at this time.

Exit interview conducted and copy or report printed for back up Administrator.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2