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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197607726
Report Date: 06/06/2025
Date Signed: 06/06/2025 04:28:12 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/11/2024 and conducted by Evaluator Evelin Rios
COMPLAINT CONTROL NUMBER: 31-AS-20241211135010
FACILITY NAME:WILLIAM J. "PETE" KNIGHT VETERANS HOME-LANCASTERFACILITY NUMBER:
197607726
ADMINISTRATOR:EDINA LEMUSFACILITY TYPE:
740
ADDRESS:45221 30TH STREET WESTTELEPHONE:
(661) 974-7035
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY:60CENSUS: 36DATE:
06/06/2025
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Edina Lemus, Administrator and Wendi Doyon, Assistant AdministratorTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff requests gifts from residents.
Staff interferes with Resident Council meetings.
INVESTIGATION FINDINGS:
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On 06/06/25, Licensing Program Analyst (LPA) Evelin Rios arrived at the facility mentioned above for an subsequent complaint visit to deliver findings on the above allegations. LPA was greeted by security and asked to sign in. LPA met with the Administrator, Edina Lemus and Assistant Administrator, Wendi Doyon. LPA explained the purpose of the visit. Entrance interview conducted. LPA requested a copy of the resident roster and personnel report.

To investigate the allegations LPA Rios conducted an initial complaint visit on 12/16/24 in conjunction with an Annual Required visit. On 12/16/24 from 10:30 a.m. to 12:00 p.m., LPA conducted a physical plant tour of the facility with Agnieszka Sibbitt, the Supervisory Registered Nurse. At approximately 4:07 p.m., LPA obtained a copy of the facility's policies. LPA interviewed administrator at 4:33 p.m. On 04/14/25 LPA Rios conducted an annual continuation visit, during that visit LPA toured two (02) bedrooms and interviewed two (02) residents. On 05/28/2025 LPA Rios interviewed seven (07) residents, the assistant administrator and five (05) staff. (Continue to LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2025
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 31-AS-20241211135010
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: WILLIAM J. "PETE" KNIGHT VETERANS HOME-LANCASTER
FACILITY NUMBER: 197607726
VISIT DATE: 06/06/2025
NARRATIVE
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(Continued from LIC9099)

Allegation: Staff requests gifts from residents. Regarding the allegation, it was reported that, staff will make requests from residents for certain baked goods or sweets as well as accept gifts from residents. During an interview conducted by LPA on 12/16/24, the administrator denied this allegation. Additionally, interviews with nine (09) residents on 04/14/25 and 05/28/25 corroborated that they had not been asked by staff for any gifts. Two (02) residents stated that the facility discourages residents from gifting staff, citing an strict facility policy. LPA's interview with resident #3 (R3) revealed that they enjoy purchasing candy on Valentine’s Day and distributing it to everyone. R3 expressed disagreement with the policy, stating that they wish to show appreciation to staff. LPA was unable to find corroborating evidence to support the allegation. Based on the interviews, the allegation is deemed Unsubstantiated at this time.


Allegation: Staff interferes with Resident Council meetings. Regarding the allegation it was reported that staff regularly attend the Resident Council meetings without invite which causes residents to not feel free to discuss matters. An interview conducted by LPA with the assistant administrator on 05/28/2025 revealed that, at least in their case, they were invited by a Resident Council member and have not been informed that their presence is a concern. Additionally, an interview with one (01) staff member who attends the meetings indicated that they were invited and provide assistance through note-taking. LPA confirmed with the Resident Council member that they did invite staff to attend meetings and has not rescinded the invitation. Of the nine (09) residents interviewed on 04/14/2025 and 05/28/2025, six (06) stated that they participate in Resident Council meetings. Among them, one (01) resident expressed concerns about staff presence and participation in meeting discussions. However, this resident also believes that staff were invited and that the issue has not been formally addressed among residents or staff. Further interviews with five (05) out of the seven (07) residents who attend meetings revealed that they have no concerns or issues regarding staff participation or presence. Based on these interviews, the allegation is deemed Unsubstantiated at this time.

No deficiencies issued. Exit interview. Report signed and delivered.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

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