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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602950
Report Date: 11/10/2025
Date Signed: 11/10/2025 12:32:15 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 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
10/27/2025 and conducted by Evaluator Christian Gutierrez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251027082759
FACILITY NAME:LAKEWOOD PARK MANORFACILITY NUMBER:
198602950
ADMINISTRATOR:CYNTHIA FLORESFACILITY TYPE:
740
ADDRESS:12045 LAKEWOOD BLVDTELEPHONE:
(562) 923-4417
CITY:DOWNEYSTATE: CAZIP CODE:
90242
CAPACITY:160CENSUS: 125DATE:
11/10/2025
UNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Lauren Cabaron Business Office ManagerTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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9
Staff do not ensure residents are spoken to in a respectful manner
Staff do not ensure all residents are provided meals
Staff does not ensure medications are dispensed as prescribed
INVESTIGATION FINDINGS:
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5
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13
Licensing Program Analyst (LPA) Christian Gutierrez conducted a subsequent complain visit in regard to the allegations listed above. LPA met with Business Office Manager Lauren Cabaron who assisted with today’s visit.

The investigation consisted of the following: During the initial visit conducted on 11/04/2025, LPA interviewed Administrator, staff 1- staff 3 (S1-S3) and residents 2 - residents 10 (R2-R10). LPA obtained copies of the following documents: staff roster, resident roster, R1’s physicians reports, identification information (LIC 601), face sheet, preplacement appraisal (LIC 603), appraisal needs and service plan (LIC 625), and physicians order. During today’s visit LPA Gutierrez interviewed staff 4-staff 7 (S4-S7) reviewed random residents’ medication and delivered findings.

SEE LIC 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2025
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-20251027082759
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: LAKEWOOD PARK MANOR
FACILITY NUMBER: 198602950
VISIT DATE: 11/10/2025
NARRATIVE
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In regard to the allegation “Staff do not ensure residents are spoken to in a respectful manner”, it is alleged that staff are speaking to residents in a rude and disrespectful manor sometimes even cursing at residents. During interviews with Administrator and staff eight (8) out of eight (8) stated that they do not speak to any residents in a rude or disrespectful manor. Administrator stated that R1 has never had any issues with staff until recently. All staff stated they have never cured at a resident. During interviews with residents nine (9) out of ten (10) residents stated that staff have never spoken to them in a rude or disrespectful way. Nine residents stated that staff has never cursed them.

In regard to the allegation “Staff do not ensure all residents are provided meals”, it is alleged that staff do not provide meals and drinks to residents if staff does not like them. During interviews with Administrator and staff eight (8) out of eight (8) stated that all residents receive three meals a day. All staff stated they never withhold food or drinks from any residents regardless of how they felt about them. S6 stated that R1 would bring a container for second servings and was never denied. During interviews with residents nine (9) out of nine (9) residents stated that they all receive three meals a day and have never been denied food or water by staff. R4 stated the kitchen has gotten so much better over the last year.

In regard to the allegation” Staff does not ensure medications are dispensed as prescribed”, it is alleged that staff is giving out the wrong dosage of medication. During interviews with Administrator and staff eight (8) out of eight (8) staff stated that to their knowledge medication is given correctly as prescribed by physician. LPA did random medication checks on residents and found no discrepancies. During interviews with residents nine (9) out of ten (10) residents stated they have had no problems with there medication. Nine (9) residents stated that they are given the correct dosage as prescribed by the physician.

Based on interviews conducted and records reviewed, there is insufficient evidence to support the 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. An exit interview was conducted, and a copy of this report was given to Lauren Cabaron.

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Christian Gutierrez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2