<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005569
Report Date: 10/07/2022
Date Signed: 10/11/2022 04:23:37 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, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/01/2022 and conducted by Evaluator Shobhana Frank
COMPLAINT CONTROL NUMBER: 22-AS-20220801163225
FACILITY NAME:VILLA CHRISTINAFACILITY NUMBER:
306005569
ADMINISTRATOR:ATENCIO, CHRISTINA MFACILITY TYPE:
740
ADDRESS:11651 MARTHA ANN DRTELEPHONE:
(310) 953-5518
CITY:LOS ALAMITOSSTATE: CAZIP CODE:
90720
CAPACITY:6CENSUS: 5DATE:
10/07/2022
UNANNOUNCEDTIME BEGAN:
10:55 AM
MET WITH:Staff Juwan RexTIME COMPLETED:
12:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
The facility having a problem with cockroaches
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Shobhana Frank for the purpose of delivering findings for the investigation into the above identified complaint allegation. LPA met with the Staff Juwan Rex and explained the reason for today’s visit.
During the visit LPA Frank interviewed Licensee who reported that the facility has this problem from May 2022. Wipe out pest control has been servicing the facility monthly . Pest control Service was on :6/14/22 then 7/18/22 and 8/4/22. Family and resident are always informed of pest control schedule. Facility will continue servicing every month. Family & resident are advised to avoid storing/ leaving food at resident bedroom and not to leave food trash at resident room. Because the family brings food for the residents and store and leave food in their bedrooms. License had advised Family & residents to avoid storing/ leaving food at resident bedroom and not to leave food trash at resident room. Family and resident are always informed of pest control schedule. Wipe out pest control has been servicing the facility monthly . Pest control Service was on :6/14/22 then 7/18/22 and 8/4/22.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Shobhana Frank
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2022
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 22-AS-20220801163225
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: VILLA CHRISTINA
FACILITY NUMBER: 306005569
VISIT DATE: 10/07/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Based on interview of licensee and review of Wipe out pest control services plan and observation facility has problem of cockroaches but license was already fixing the problem, LPA toured the facility and did not observed any cockroaches, this allegation of the facility having a problem with cockroaches, is Unsubstantiated.
An exit interview was conducted with facility representative and a copy of this report provided.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Shobhana Frank
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2