198204972-9-17-2026-11-AS-UCOL-DY5N26-20260921100413

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198204972
Report Date: 09/17/2026
Date Signed: 09/17/2026 03:51:51 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/30/2026 and conducted by Evaluator Socorro Leandro

COMPLAINT CONTROL NUMBER: 11-AS-20260130154914

FACILITY NAME:	ROSECRANS VILLA RESIDENTIAL CARE		FACILITY NUMBER:	198204972
ADMINISTRATOR:	SANDRA LOPEZ		FACILITY TYPE:	740
ADDRESS:	14110 CORDARY AVENUE		TELEPHONE:	(310) 675-9163
CITY:	HAWTHORNE	STATE: CA	ZIP CODE:	90250
CAPACITY:	135	CENSUS: 110	DATE:	09/17/2026
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Administrator - Sandra Lopez		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff failed to ensure a resident received meals.

INVESTIGATION FINDINGS:

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On 09/17/2026, Licensing Program Analyst (LPA) Socorro Leandro conducted an unannounced complaint investigation visit regarding the allegations listed above. LPA met with the Administrator, Sandra Lopez, and the purpose of the visit was explained. LPA was granted entry to the facility.

Investigation consisted of the following:

On 02/04/2026, a facility tour was conducted, interviews were conducted, and records were gathered. Resident 2 (R2) to Resident 13 (R13) and Staff 1 (S1) to Staff 7 (S7) were interviewed. Facility records were gathered which consisted of Resident Rosters, Employee Roster, Meal Menus, and Resident 1’s (R1) records. On 03/10/2026, Resident 1 (R1) and Witness 1 (W1) were interviewed. On 09/17/2026, records were reviewed.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2026

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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Control Number 11-AS-20260130154914

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: ROSECRANS VILLA RESIDENTIAL CARE	FACILITY NUMBER: 198204972
	VISIT DATE: 09/17/2026

NARRATIVE

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Investigation revealed the following:

Allegation: “Staff failed to ensure a resident received meals”, it is being alleged that staff failed to ensure that R1 received their meals.

Interviews conducted with S1 to S7 revealed the following: 7 out of 7 staff denied the allegation, furthermore, staff explained that they walked R1 to the dining room, brought them meals to their bedroom, and provided them with alternative meal options.

Interviews conducted with R1 to R13 revealed the following: 13 out of 13 residents denied the allegation, additionally, R1 explained that staff brought them food, provided them with yogurt and alternative meal options, and staff never denied them of food, moreover, R1 explained that they did not like eating everything because they believed there was poison in the food. (Residents who were interviewed were composed of residents who required assistance with meals, for example, staff provided them with meal trays to their rooms.)

Observations on 02/04/2026 revealed the following: Lunch time was observed and residents were observed being served a balanced meal with protein, carbohydrates, and vegetables, furthermore, residents who requested seconds were provided with a second plate. Staff were observed taking meal trays to residents’ rooms.

Meal Menus reviewed revealed the following: Breakfast, lunch, and dinner are composed of balanced meals with portions of carbohydrates, protein, vegetables, and a side of dessert. The facility also provides snacks.

Based on the interviews, observations, records reviewed this allegation is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted, and a copy of this report was left with the Administrator, Sandra Lopez.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2026

LIC9099 (FAS) - (06/04)

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