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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 405802287
Report Date: 03/19/2025
Date Signed: 03/19/2025 11:11:15 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/12/2025 and conducted by Evaluator Rachael De Leon
COMPLAINT CONTROL NUMBER: 29-AS-20250312142835
FACILITY NAME:GARDEN VIEW INNFACILITY NUMBER:
405802287
ADMINISTRATOR:KOC DE JONG, DIMFNAFACILITY TYPE:
740
ADDRESS:7105 SAN GABRIEL RDTELEPHONE:
(805) 462-2273
CITY:ATASCADEROSTATE: CAZIP CODE:
93422
CAPACITY:15CENSUS: 13DATE:
03/19/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Dimfna Koc De Jong, AdministratorTIME COMPLETED:
11:20 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Toxic substances were made accessible to residents in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) De Leon conducted a 10 day complaint visit to the facility above. LPA met with Dimfna Koc De Jong, Administrator and explained the purpose of the visit.
LPA toured the inside of the facility and checked the doors that go to the medications, cleaners, laundry products and personal grooming and hygiene items. All doors were locked with a key and have a sign in each door "Keep door locked, Put key back in spot!". Administrator stated staff are trianed to keep items locked and inaccessible to residents in care. LPA took photographs and video of the locked doors. LPA did not find any items that could pose a harm to residents in care accessible at the facility. Wintess 1 indicated the doors were unlocked on two occasions leaving the room accessible to residents in care. Based on the evidence at this time the allegations is deemed Unsubstantiated.
LPA provided an technical advisory and had a discussion with Administrator on the importance of making sure staff are locking the doors when exiting the rooms with cleaners, medication, personal grooing products and not allowing accesibility by residents in care.
Exit interview conducted and copy of report printed for Administrator.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 03/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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