198601704-4-9-2025-11-AS-SCIS-DHWUNM-20250623154407

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601704
Report Date: 04/09/2025
Date Signed: 04/09/2025 09:22:08 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
03/26/2025 and conducted by Evaluator Bernadette Allen

COMPLAINT CONTROL NUMBER: 11-AS-20250326171613

FACILITY NAME:	HARMONY HOME CARE		FACILITY NUMBER:	198601704
ADMINISTRATOR:	DIONSIO, ANTONIA		FACILITY TYPE:	740
ADDRESS:	1318 215TH STREET		TELEPHONE:	(310) 549-0218
CITY:	CARSON	STATE: CA	ZIP CODE:	90745
CAPACITY:	6	CENSUS: 3	DATE:	04/09/2025
		UNANNOUNCED	TIME BEGAN:	08:32 AM
MET WITH:	Antonia Dionsio-Administrator		TIME COMPLETED:	09:36 AM

ALLEGATION(S):

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Facility did not safeguard resident’s belongings.

INVESTIGATION FINDINGS:

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On 4/9/2025, at 8:32 AM, Licensing Program Analyst (LPA) Bernadette Allen conducted an unannounced visit to deliver findings for the alleged allegation. LPA identified herself and met Susan Parungao-Caregiver who was informed of the purpose of the visit.

The investigation consisted of the following:

On 4/3/2025 at 2:45 PM, LPA Allen obtained and reviewed files for Resident 1 (R1), which included face sheet, medication list, appraisal, needs and services plan, physicians report, admissions agreement with personal property valuables list, and staff and client roster. LPA Allen conducted interviews with Staff 1- Staff 2 (S1 - S2), Residents 1- resident 3 (R1 -R3).

Continued

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20250326171613

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: HARMONY HOME CARE	FACILITY NUMBER: 198601704
	VISIT DATE: 04/09/2025

NARRATIVE

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Investigation revealed the following:

Allegation: Facility did not safeguard resident’s belongings

On 4/3/2025 LPA interviewed Staff 1- Staff 2 (S1 - S2), 2 out of 2 staff members stated that R1’s personal belongings were safeguarded and not stolen by anyone. They also confirmed that R1’s personal items had been picked up and accounted for by an outside party.

On 4/7/2025 at 11:58 AM, LPA Allen interviewed R1, who stated they were not unaware of their personal belongings being stolen by any staff. R1 affirmed that all their possessions were in their care and emphasized that no items had ever been stolen by staff members. During the interview LPA Allen asked about specific items that were allegedly missing, and Resident 1 (R1) stated all their items were accounted for. Additionally, LPA Allen reviewed R1’s personal property and valuables log and appeared to be up to date. LPA also attempted to interview resident 2 (R2) who was not willing to be interviewed and resident 3 (R3) stated their personal belongings have not been stolen by staff.

Based on the evidence gathered during the investigation, the above allegation is found to be Unsubstantiated; meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

An exit interview was conducted where this report was discussed and provided to Antonia Dionsio- Administrator at the conclusion of the visit.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Bernadette Allen
LICENSING EVALUATOR SIGNATURE:	DATE: 04/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2025

LIC9099 (FAS) - (06/04)

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