198320317-11-6-2025-11-AS-SCIS-DNS479-20251125175047

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320317
Report Date: 11/06/2025
Date Signed: 11/06/2025 11:08:46 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/30/2025 and conducted by Evaluator Felisa Shirley

COMPLAINT CONTROL NUMBER: 11-AS-20250930163648

FACILITY NAME:	CASA ESPERANZA		FACILITY NUMBER:	198320317
ADMINISTRATOR:	AGATEP, EVANGELINE		FACILITY TYPE:	740
ADDRESS:	1080 VIA LA PAZ		TELEPHONE:	(310) 787-7300
CITY:	SAN PEDRO	STATE: CA	ZIP CODE:	90732
CAPACITY:	6	CENSUS: 6	DATE:	11/06/2025
		UNANNOUNCED	TIME BEGAN:	09:32 AM
MET WITH:	Melanie Tallada, Assistant Administrator		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff kicks resident’s personal belongings
Staff spits in resident’s food
Staff had sex in the facility within sight of resident

INVESTIGATION FINDINGS:

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On 11/6/25, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced visit to this facility. LPA was met by the Administrator Assistant, Melanie Tallada and explained the purpose of the visit is to investigate and deliver findings for the allegations mentioned above. LPA was granted access to the facility.

The investigation consisted of the following:
On 10/2/25 LPA Shirley reviewed copies of the following records: Staff and Resident Roster, residents file, Employee’s Annual Training records, Identification and Emergency Information form, Physician’s Report, Appraisals Needs/Services plan, Admission Agreement, House Rules, Residents Personal Property and Valuables list. LPA Felisa Shirley conducted a tour of the facility. LPA Shirley interviewed Staff 1 – Staff-4 (S1 – S4), and Resident -1 – Resident -6 (R1-R6).

The investigation revealed the following:
Con'd on 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025

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 11-AS-20250930163648

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: CASA ESPERANZA	FACILITY NUMBER: 198320317
	VISIT DATE: 11/06/2025

NARRATIVE

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Allegation: Staff kicks resident’s personal belongings

It is being alleged that staff kicked R1’s personal belongings. On 10/2/25, LPA Felisa Shirley interviewed S1 and she stated that while cleaning R1’s room, she moved an item out of the way with her foot. Interview with S1, revealed that staff used foot to move an item on the floor while cleaning, but nothing was kicked. On 11/6/25, LPA Shirley reviewed staffs sign-in sheets for annual trainings on residents rights.

LPA interviewed staff 1 – staff 4 (S-1 – S-4). Of those interviewed 4 out of 4 denied the allegation. LPA interviewed resident 1 – resident 6 (R1 – R6). Of those who interviewed 5 out of 6 denied the allegation, 1 confirmed the allegation.

Based on information gathered, LPA did not find sufficient evidence to support the allegation “Staff kicks resident’s personal belongings,” therefore, the allegation is unsubstantiated.

Allegation: Staff spits in resident’s food

It is being alleged that staff has spit in residents food. On 11/6/25, LPA Shirley spoke with the Administrator regarding the staffs food safety protocols which includes the coverings of residents meals when residents are not present. On 10/2/25, LPA Shirley observed that the facility has an open kitchen in which an individual can observe the food preparation. LPA Shirley also observed the staff covering the residents meals with a plastic cover whenever the resident left the table.

LPA Shirley interviewed staff 1 – staff 4 (S-1 – S-4). Of those interviewed 4 out of 4 denied the allegation. LPA interviewed resident 1 – resident 6 (R1 – R6). Of those who interviewed 5 out of 6 denied the allegation, 1 was not sure.

Based on information gathered, LPA did not find sufficient evidence to support the allegation “Staff spits in resident’s food,” therefore, the allegation is unsubstantiated.

Con'd on 9099-C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20250930163648

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: CASA ESPERANZA	FACILITY NUMBER: 198320317
	VISIT DATE: 11/06/2025

NARRATIVE

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Allegation: Staff had sex in the facility within sight of resident

It is being alleged that R1 witnessed S1 and S2 having sexual intercourse in this facility. On 10/2/25, LPA Shirley interviewed staff 1 – staff 4 (S-1 – S-4). Of those interviewed 4 out of 4 denied the allegation. LPA interviewed resident 1 – resident 6 (R1 – R6). Of those who interviewed 5 out of 6 denied the allegation and 1 confirmed the allegation.

Based on information gathered, LPA did not find sufficient evidence to support the allegation “Staff had sex in the facility within sight of resident,” therefore, the allegation is unsubstantiated.

No deficiencies were cited for these allegations.

An exit interview was conducted and a copy of this report was provided to the Assistant Administrator, Melanie Tallada.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Felisa Shirley
LICENSING EVALUATOR SIGNATURE:	DATE: 11/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2025

LIC9099 (FAS) - (06/04)

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