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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197606651
Report Date: 12/02/2025
Date Signed: 12/02/2025 02:29:30 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/25/2025 and conducted by Evaluator Christian Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251125123813
FACILITY NAME:LAKEWOOD GARDENSFACILITY NUMBER:
197606651
ADMINISTRATOR:MARIE JEENE R DE CASTROFACILITY TYPE:
740
ADDRESS:12055 S. LAKEWOOD BLVD.TELEPHONE:
(562) 869-4038
CITY:DOWNEYSTATE: CAZIP CODE:
90242
CAPACITY:150CENSUS: 81DATE:
12/02/2025
UNANNOUNCEDTIME BEGAN:
09:39 AM
MET WITH:Marie Jenne De Castro AdmiistratorTIME COMPLETED:
02:40 PM
ALLEGATION(S):
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Staff did not ensure that the facility was free of scabies.
Staff did not address resident's change in condition.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christian Gutierrez conducted an unannounced complaint visit in response to the above allegations. LPA met with Administrator Marie Jeene De Castro who assisted with today’s visit.

On today’s visit, LPA interviewed Administrator, Staff 1-staff 6 (S1-S6) and residents 1- residents 5 (R1-R5). LPA obtained copies of the following documents: Staff roster, resident roster, R1’s physicians reports, identification information, hospital discharge paperwork, wound progress notes, unusual incident report (LIC 624), and body assessment charts. LPA Gutierrez also delivered findings.

SEE LIC 8099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
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 28-AS-20251125123813
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: LAKEWOOD GARDENS
FACILITY NUMBER: 197606651
VISIT DATE: 12/02/2025
NARRATIVE
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In regard to the allegation “Staff did not ensure that the facility was free of scabies”, It is alleged that R1 was admitted to emergency for an unwitnessed fall and upon exam it was discovered R1 had scabies. During interview with Administrator, and staff five (5) out of seven (2) stated that they did not observe R1 to have any rash. Administrator stated that the Dermatologist came on 11/19/2025 and only treated R1 for redness around sacral/buttocks. S1 and S3 stated there was a little rash on back but was not reported. During interviews with residents four (4) out of five (5) residents stated that they have had no rash. During record review LPA obtained hospital discharge paperwork that stated R1 had scabies along with instruction for medications and the need for isolation.

In regard to the allegation “Staff did not address resident's change in condition”, It is alleged that R1 was not treated for skin condition prior to be admitted to hospital on an unrelated manner. Treating physician reported R1 had scabies and treatment was initiated due to the resident's skin condition/symptoms. During interview with Administrator, and staff seven (7) out of seven (7) stated that there was no report of a change of condition. Administrator stated that dermatologists are at facility weekly and no report of rash was reported. During interviews with residents five (5) out of five (5) residents stated that they have had no problems with rashes. During record review it was revealed that on 11/18/2025 body assessment chart indicated little red spots on lower neck.In house Dermatologist was at facility on 11/19/2025 and did not address body part that was reported by caregiver

Based on record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Deficiencies are being cited according to California Code of Regulations, Title 22 and Health and Safety Code. An exit interview was conducted, and a copy of this report was provided.

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20251125123813
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: LAKEWOOD GARDENS
FACILITY NUMBER: 197606651
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/02/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type A
12/03/2025
Section Cited
CCR
87468.1(a)(2)
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87468.1 Personal Rights of Residents in All Facilities
(a) Residents in all residential care facilities for the elderly shall have all of the following personal rights:
(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment.

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Administrator will insure residents are checked for rashes and insure proper training with staff on section 87468.1(a)(2) is conducted. Administrator will submit training to LPA by POC due date.
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Based on observations and interviews licensee did not ensure, R1 was fee and clear of scabies in facility which poses an immediate risk to the health, safety, and personal rights of the persons in care.




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Deficiency Dismissed
Type A
12/03/2025
Section Cited
CCR
87466
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87466 Observation of the Resident The licensee shall ensure that residents are regularly observed for changes in physical, mental, emotional and social functioning and that appropriate assistance is provided when such observation reveals unmet needs. When changes such as unusual weight gains or losses or deterioration of mental ability or a physical health condition are observed, the licensee shall ensure that such changes are documented and brought to the attention of the resident's physician and the resident's responsible person, if any.
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Administartor will conduct training on section 87466 and submit to LPA by POC due date.
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Based on observations and interviews licensee did not ensure, R1 was checked for a change of conditon like rashes on body which poses an immediate risk to the health, safety, and personal rights of the persons in care.
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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: David Sicairos
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3