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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603550
Report Date: 11/03/2025
Date Signed: 11/03/2025 01:35:58 PM

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
10/27/2025 and conducted by Evaluator Alberto Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20251027202259
FACILITY NAME:WEST PARK SENIOR LIVINGFACILITY NUMBER:
198603550
ADMINISTRATOR:JERI MILESFACILITY TYPE:
740
ADDRESS:801 CYPRESS WAYTELEPHONE:
(909) 592-8844
CITY:SAN DIMASSTATE: CAZIP CODE:
91773
CAPACITY:200CENSUS: 108DATE:
11/03/2025
UNANNOUNCEDTIME BEGAN:
10:38 AM
MET WITH:Jeri Hillery, Administrator/Executive Director TIME COMPLETED:
01:46 PM
ALLEGATION(S):
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Staff do not provide adequate supervision to residents.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alberto Lopez made an unannounced visit to investigate the above allegation. LPA met with Jeri Hillery, Administrator/Executive Director, and discussed the purpose of the visit.

The investigation consisted of reviewing and obtaining resident and staff rosters, interviewing four (4) staff, ten (10) residents, obtaining copy of rental agreement, and R1 physician’s report and other pertinent medical information.

The investigation revealed regarding allegation: Staff do not provide adequate supervision to residents. It is alleged that residents from the fifth (5th) floor and lower floors are accessing floors six (6) and seven (7) and trying to get into the rooms.

(continued on 9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

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

DATE: 11/03/2025
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-20251027202259
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: WEST PARK SENIOR LIVING
FACILITY NUMBER: 198603550
VISIT DATE: 11/03/2025
NARRATIVE
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(continued from 9099)

LPA interviewed four (4) staff, and all four (4) staff denied the allegation. All staff stated they knew who the resident is that is going up to those floors. One staff member stated that resident wants to move to either the 6th or 7th floor and went up to see the rooms. Staff stated that they have told the resident that they can provide resident with a tour. Staff stated they cannot prevent residents from 5th floor and lower from accessing floors six (6) or seven (7) since it is all part of the facility and residents have right to the common areas on floors six (6) and seven (7). LPA interviewed ten (10) residents, and nine (9) of ten (10) residents could not corroborate the allegation. One (1) resident heard about an incident involving R1 trying to open door of one resident on 7th floor. R1 stated R1 has gone up to the 7th floor to see the rooms because R1 would like to move up there because those rooms have a microwave and stove. R1 denied going into any of the rooms. All ten residents stated they have never had any items missing from their rooms. R1 does not require a 1:1 and is clear and oriented according to physician’s report. There is insufficient evidence to support this 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 is Unsubstantiated.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:

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

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