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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 335530171
Report Date: 08/01/2025
Date Signed: 08/01/2025 12:21:24 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, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/28/2025 and conducted by Evaluator Javier Prieto
COMPLAINT CONTROL NUMBER: 56-AS-20250728122130
FACILITY NAME:WILDOMAR SENIOR ASSISTED LIVINGFACILITY NUMBER:
335530171
ADMINISTRATOR:KAREN ROPERFACILITY TYPE:
740
ADDRESS:32365 SOUTH PASADENA STTELEPHONE:
(323) 902-6000
CITY:WILDOMARSTATE: CAZIP CODE:
92595
CAPACITY:200CENSUS: 123DATE:
08/01/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Karen Roper, Executive Director TIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff do not ensure the facility is kept in sanitary conditions for residents in care
Staff do not ensure facility is kept free of mal odors
Staff do not ensure residents receive clean linens
Staff do not ensure residents are provided with adequate eating utensils
Licensee does not ensure staff are adequately trained to perform care for residents
Staff do not ensure required posters are placed prominently in the facility
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Javier Prieto arrived to the facility to conduct a complaint investigation regarding the above allegations. LPA Prieto met Executive Director Roper and discussed the elements of the complaint.

Allegation #1 - The facility is a 2 story, 4 wing facility. LPA toured facility hallways, library, common areas, med tech room, linen and storage rooms, laundry room, dinning area, kitchen and common bathrooms. LPA also toured the facility grounds. LPA found these areas to be clean and sanitary.

Allegation #2 - The facility is a 2 story, 4 wing facility. LPA toured facility hallways, library, common areas, med tech room, linen and storage rooms, laundry room, dinning area, kitchen and common bathrooms. LPA also toured the facility grounds. LPA found these areas to be from odors.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2025
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 56-AS-20250728122130
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
, CA 92507
FACILITY NAME: WILDOMAR SENIOR ASSISTED LIVING
FACILITY NUMBER: 335530171
VISIT DATE: 08/01/2025
NARRATIVE
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Allegation #3 - LPA toured facility hallways, library, common areas, med tech room, linen and storage rooms, laundry room, dinning area, kitchen and common bathrooms. LPA observed facility storage room to have more than an ample supply of linen or resident use. Executive Director Roper states the rooms are supplied with fresh linens, as well as cleaning of the rooms, once a week and changing of linens when necessary.

Allegation #4 - LPA toured facility hallways, library, common areas, med tech room, linen and storage rooms, laundry room, dinning area, kitchen. LPA arrived to the dinning area, during a meal time, and found the kitchen to be clean and organized with an adequate amount eating utensils.

Allegation #5 - LPA obtained sample training documents from Executive Director Roper showing proper training for direct care staff in the topics of resident rights, meals, cleaning, activities of daily living, bedridden clients, lifting and transferring. Other topics include, incontinence, communicating, positioning and personal care, UTI and preparing for end of life. Medical staff are trained in the topics of medications, person centered care plans, catheter and perineal care, cognitive impairment and specialized diets and nutrition.

Allegation #6 - LPA observed, during facility tour, posting of required posters such as Licensing required Complaint Poster and the poster for the Long Term Care Ombudsman each posted in prominent locations at the facility.

Based on the information obtained there is not enough evidence to support the allegations made in this complaint. Therefore, the allegations are deemed UNSUBSTANTIATED at this time. This report was signed by LPA Prieto and Executive Director Roper and a copy was left with the facility.
SUPERVISORS NAME: Karen Clemons
LICENSING EVALUATOR NAME: Javier Prieto
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2