197608232-1-2-2026-11-AS-SCIS-DRN2BE-20260225161500

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608232
Report Date: 12/29/2025
Date Signed: 01/02/2026 03:27:35 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/23/2025 and conducted by Evaluator Pamela Bunker

COMPLAINT CONTROL NUMBER: 11-AS-20251223101427

FACILITY NAME:	SUMMER HOUSE AT LADERA HEIGHTS		FACILITY NUMBER:	197608232
ADMINISTRATOR:	SHERRYL RAFOLS		FACILITY TYPE:	740
ADDRESS:	6108 DAMASK AVENUE		TELEPHONE:	(323) 792-4105
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90056
CAPACITY:	4	CENSUS: 4	DATE:	12/29/2025
		UNANNOUNCED	TIME BEGAN:	09:40 AM
MET WITH:	Marilynn Yniestas		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff yelled at the resident.
Staff made inappropriate comments towards the resident.

INVESTIGATION FINDINGS:

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On December 29, 2025, at 9:40 a.m., Licensing Program Analyst (LPA) Pamela Bunker conducted an initial visit to gather information regarding the above allegations. LPA met with Marilyn Nery, caregiver, and spoke to Mark Loo, Licensee/Administrator, and explained the purpose of the visit. LPA was granted entry to the facility.

The investigation consisted of the following: On December 29, 2025, the following documents were reviewed and/or obtained as part of the investigation: Personnel Report (dated 12/29/2025), Resident Roster (dated 12/29/2025), Admission Agreement (dated 10/28/2025) Identification and Emergency Information (dated 11/25/2025), Physician’s Report (dated 10/23/2025), Medical Assessment (dated 10/14/2025), Medication Administration Records (MARs) (dated 10/28/2025-12/29/2025), Appraisal & Needs and Services Plan (dated 10/28/2025), Functional Capability Assessment (dated 10/28/2025 ), Preplacement Appraisal Information (dated 10/14/2025), Personal Rights (dated 10/28/2025), Consent Forms (dated 10/28/2025 ), and In-Service Training (dated 03/17/2025). See continued LIC9099-C page 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 12/29/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025

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 11-AS-20251223101427

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: SUMMER HOUSE AT LADERA HEIGHTS	FACILITY NUMBER: 197608232
	VISIT DATE: 12/29/2025

NARRATIVE

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Continued LIC9099-C page 2.
On 12/29/2025, between 10:00 a.m. and 3:30 p.m., LPA Pamela Bunker conducted interviews with staff members #1–#3 (S1–S3) and residents #2–#4 (R2–R4). Resident #1 (R1) was interviewed by telephone.

The investigation revealed the following.
Allegation: Staff yelled at the resident.
The LPA interviewed staff members #1–3 (S1–S3). All three staff members (3 out of 3) consistently stated that staff do not yell at residents and that Resident #1 (R1) has never been yelled at by anyone in the facility. 3 out of 3 staff members reported that all residents are treated with dignity and respect. They also stated that residents have personal relationships with staff and that the facility maintains a zero‑tolerance policy regarding inappropriate conduct. 3 out of 3 staff members indicated that each resident is provided with a safe, healthful environment and comfortable accommodations. All three staff members confirmed they have never witnessed any staff member yelling at a resident. S1–S3 denied the allegation.

Residents #1–#4 (R1–R4) stated that staff do not yell at residents and that staff provide adequate care and supervision. 4 out of 4 residents reported that staff are always available to assist and consistently check on residents. Resident #1 (R1) stated that the staff did not yell at them, and 3 out of 4 residents confirmed they had not witnessed any staff member yelling at R1. R1–R4 reported that their daily needs are being met and that they are happy living at the facility, expressing no problems or concerns. All four residents denied the allegation.

Allegation: Staff made inappropriate comments towards the resident.
The LPA interviewed staff members #1–3 (S1–S3). All three staff members (3 out of 3) stated that no inappropriate comments were made toward the resident. S1–S3 reported that all residents are treated with dignity and respect and that the facility maintains a zero-tolerance policy for inappropriate conduct. They further stated that residents are free from corporal or unusual punishment and are provided with a safe, healthful environment and comfortable accommodations. All three staff members also stated that the staff did not attempt to send Resident #1 (R1) to a medical appointment alone.

See continued LIC812-C page 2.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 12/29/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20251223101427

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: SUMMER HOUSE AT LADERA HEIGHTS	FACILITY NUMBER: 197608232
	VISIT DATE: 12/29/2025

NARRATIVE

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Continued LIC812-C page 3.

S1–S3 clarified that S1 never made the comment, “Why don’t you have relatives to help you?” S1 explained that R1 had been receiving medical transportation through Kaiser Permanente, but once R1’s transportation credits were exhausted, the facility assisted in arranging alternative transportation options. S1–S3 denied the allegation and stated they have never witnessed any staff member making inappropriate comments toward any resident.

Residents #2–#4 (R2–R4) stated that staff do not make inappropriate comments toward R1. Resident #1 (R1) stated that staff have never made any inappropriate comments toward them. 4 out of 4 residents reported that they have never witnessed staff speaking inappropriately to any resident. R1–R4 also stated that they are happy living at the facility and have no problems or concerns. All four residents denied the allegation.

LPA Bunker reviewed Resident #1’s (R1) file, including the Admission Agreement dated October 28, 2025, which was signed and confirmed that the facility does not provide transportation to the resident.

LPA Bunker also reviewed R1’s medical records from Kaiser Permanente West Los Angeles Medical Center dated November 23, 2025, and December 4, 2025, which showed that medical care and transportation services were being provided.

Based on interviews, available evidence, observation, information received, and records reviewed there was not enough sufficient evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed unsubstantiated.

A copy of the Complaint Investigation Report LIC9099 and LIC9099-C was provided to the .

No deficiencies were cited.

An exit interview was conducted.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 12/29/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/29/2025

LIC9099 (FAS) - (06/04)

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