198601838-8-9-2025-28-AS-DSIS-DKSP9U-20250822110740

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601838
Report Date: 08/09/2025
Date Signed: 08/09/2025 09:45:26 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
08/05/2025 and conducted by Evaluator Tena Herrera

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250805123032

FACILITY NAME:	DOWNEY RETIREMENT CENTER		FACILITY NUMBER:	198601838
ADMINISTRATOR:	BRANDIE MENDIBLES		FACILITY TYPE:	740
ADDRESS:	11500 DOLAN AVENUE		TELEPHONE:	(562) 869-2416
CITY:	DOWNEY	STATE: CA	ZIP CODE:	90241
CAPACITY:	252	CENSUS: 132	DATE:	08/09/2025
		UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Melina Diaz - Receptionist		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Staff smoking marijuana while oxygen tanks are in use.
Staff make inappropriate comments in the presence of residents.
Staff denies resident’s milk.
Staff denies residents food.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced subsequent complaint visit to deliver findings on the above allegations. LPA spoke with Administrator Brandie Mendibles via phone and verbally delivered findings and met with Melina Diaz to sign report, the purpose of today's visit was explained.

The investigation consisted of the following:

On 8/8/25 LPA obtained copies of staff/resident rosters, toured facility dining/kitchen and interviewed 4 staff (S1-S4) and 13 residents (R1-R13).
On 8/9/25 LPA typed report and delivered findings on the above allegations.

Continued on the LIC9099-C page.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2025

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 28-AS-20250805123032

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: DOWNEY RETIREMENT CENTER	FACILITY NUMBER: 198601838
	VISIT DATE: 08/09/2025

NARRATIVE

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The investigation revealed the following:
Allegation: Staff smoking marijuana while oxygen tanks are in use.
It is alleged that kitchen staff are smoking marijuana in the smoking area and in the presence of residents with oxygen tanks. LPA interviewed 4 staff and 4 out of 4 staff denied the above allegation and stated that they do not smoke and have never seen or heard of other staff members smoking marijuana nor cigarettes. LPA interviewed 13 residents and 12 out of 13 residents denied the above allegation and stated they have never seen staff smoke cigarettes let alone marijuana. During tour LPA did not observe any odors of cigarette smell or marijuana smell.

Allegation: Staff make inappropriate comments in the presence of residents.
It is alleged that stated S2 allows staff members to speak inappropriately with each other in the presence of residents. LPA interviewed 4 staff and 4 out of 4 staff denied the above allegation and stated they have never witnessed or heard of this type of inappropriate behavior. LPA interviewed S2 and S2 stated they do not recollect the reported allegation and stated if they would have observed something like this they would report it. LPA interviewed 13 residents and 13 out of 13 residents denied the above allegation and stated they have never witnessed or heard staff speaking inappropriately in their presence.

Allegation: Staff denies resident’s milk.
It is alleged that staff will check residents refrigerator for milk and if residents have milk they will not be provided with more. LPA interviewed 4 staff and 4 out of 4 staff denied the above allegation, interviews with S1 and S2 revealed that housekeeping does inspect residents refrigerators during cleaning rounds to ensure that residents do not have any spoiled food/drinks and if removed they notify the resident and residents are able to request for replacement milk/food that has been thrown out. Interview with S3 and S4 revealed that residents often times ask for extra milk and are never denied it, they are provided milk in styrofoam cups with lids for them to take to their rooms. LPA interviewed 13 residents and 13 out of 13 residents denied the above allegation and stated they are never denied any food or drinks at facility. Interview with R12 and R4 revealed that the facility had ran out of milk at one time in July but it was replenished by the next meal.

(Continued on the LIC9099-C page)

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2025

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20250805123032

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: DOWNEY RETIREMENT CENTER	FACILITY NUMBER: 198601838
	VISIT DATE: 08/09/2025

NARRATIVE

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Allegation: Staff denies residents food.
It is alleged that residents ask staff members for an orange and are denied. LPA toured kitchen, inspected the walk-in refrigerator and observed a crate full of oranges, other crates with other fruit such as honeydew, watermelon, and pineapple. There were prepared fruit bowls ready for the residents with their requested fruit, cut and ready to serve. LPA interviewed 4 staff and 4 out of 4 staff denied the above allegation and stated that there is always fresh fruit available for the residents and if more is desired they just have to ask and kitchen staff will prepare it for them. LPA interviewed 13 residents and 13 out of 13 residents denied the above allegation and stated that staff have never denied them any food or fruit, stated that there is a fruit bar during lunch, and if they request fruit on the alternative menu it is provided to them.

Based on statements and interviews conducted with staff and residents, tour of facility and inspection of food supply, there was not enough supportive evidence to concur with the reported allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview held, and a copy of this report was emailed.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 08/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2025

LIC9099 (FAS) - (06/04)

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