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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602639
Report Date: 03/11/2025
Date Signed: 03/11/2025 02:21:56 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
03/04/2025 and conducted by Evaluator Nicol Wesley
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250304103541
FACILITY NAME:D & L RESIDENTIAL CARE HOME 2FACILITY NUMBER:
198602639
ADMINISTRATOR:RAFAEL DIAZFACILITY TYPE:
740
ADDRESS:1036 S. BARRANCA AVENUETELEPHONE:
(562) 774-7167
CITY:GLENDORASTATE: CAZIP CODE:
91740
CAPACITY:6CENSUS: 6DATE:
03/11/2025
UNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Bobby AlladoTIME COMPLETED:
01:05 PM
ALLEGATION(S):
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Staff did not intervene between residents during an altercation.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Nicol Wesley conducted an unannounced 10 day complaint visit and met with Bobby Allardo and discussed the purpose for todays visit. Shortly afterwards Administrator Rita Herrera arrived and joined the visit.

Investigation consisted of the following: LPA Wesley request to see Resident 1 and Resident 2 file, the staff and resident roster. Interviewed resident 1, 2, the administrator, and staff #1, staff #2

Investigation Revealed the folllowing: LPA Wesley interviewed resident #1 and she said she was about to leave date and time unknown, and resident #2 approached her and put his hands on her walker and asked her not to leave. She said the resident held her hands to her walker for about 1 hour and then he let her go when he realized she was not leaving. Staff #1 did not witness the incident because he was not in the front of the facility and said he asked staff #2 about it and he didn't say anything about them having an altecation. Staff #2 did not
Continued on LIC 9099C
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Nicol Wesley
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025
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 2
Control Number 28-AS-20250304103541
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: D & L RESIDENTIAL CARE HOME 2
FACILITY NUMBER: 198602639
VISIT DATE: 03/11/2025
NARRATIVE
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return the next day. The Police came to the facility on 03/14/25 at 1704 to 1732 and conducted an investigation, and didn't feel like any harm was done, or that there was a threat, so they left the facility without making a report.

Resident #1 told LPA Wesley that she is not threatened by the resident and don't plan to press any charges. LPA Wesley observed resident 2 and resident 1 around the same location and everything was running smooth. The Administrator believes it happened on 02/23/25. LPA Wesley observed Resident #1 interacting with Resident #2 and she didn't appear to be in any emotional distress.

Based on the interviews conducted with staff, residents, review of residents medical files and facility records, there was not enough supportive evidence to concur with the reported allegation. 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 allegation(s) are UNSUBSTANTIATED.

Exit interview conducted.
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Nicol Wesley
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2