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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320402
Report Date: 07/24/2026
Date Signed: 07/24/2026 02:41:34 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, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/18/2026 and conducted by Evaluator Lizeth Villegas
COMPLAINT CONTROL NUMBER: 11-AS-20260618134003
FACILITY NAME:WESTMONT OF CULVER CITYFACILITY NUMBER:
198320402
ADMINISTRATOR:DAWN M SMITHFACILITY TYPE:
740
ADDRESS:11141 WASHINGTON BLVDTELEPHONE:
(310) 736-4118
CITY:CULVER CITYSTATE: CAZIP CODE:
90232
CAPACITY:160CENSUS: 151DATE:
07/24/2026
UNANNOUNCEDTIME BEGAN:
09:21 AM
MET WITH:Executive Director Dawn SmithTIME COMPLETED:
02:55 PM
ALLEGATION(S):
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Licensee is not taking measures to keep the facility free of insects.
Staff did not conduct an accurate appraisal of resident in care.
INVESTIGATION FINDINGS:
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On 07/24/26 at 9:20 am Licensing Program Analyst (LPA) Villegas conducted a subsequent complaint visit regarding the allegation(s) above. LPA met with Executive Director Dawn Smith as the purpose of today’s visit was explained.

The investigation consisted of the following: On 06/24/26 LPA Villegas obtained copies of the staff and resident rosters, housekeeping schedule, and Orkin invoices dated: 05/05/26, 05/19/26, 06/01/26, 06/16/26, and 06/19/26. On 06/24/26 LPA also obtained copies of the following documents for Residents #1-2 (R1-R2) Emergency ID form, Pre-appraisal, Admission agreements, Physicians reports, Needs and service plans, and August health notes for the month of June 2026. On 06/24/26 and 06/25/26 LPA conducted interviews with staff #1-9 (S1-S9), and on 06/25/26 and 07/24/26 LPA
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2026
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 3
Control Number 11-AS-20260618134003
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: WESTMONT OF CULVER CITY
FACILITY NUMBER: 198320402
VISIT DATE: 07/24/2026
NARRATIVE
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conducted interviews with residents # 1-0 (R1-R10). On 07/24/26 LPA conducted a review of documents obtained for R1, and Orkin invoices dated: 05/05/26, 05/19/26, 06/01/26, 06/16/26, and 06/19/26.

The investigation revealed the following:

Allegation: Licensee is not taking measures to keep the facility free of insects.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 11-AS-20260618134003
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: WESTMONT OF CULVER CITY
FACILITY NUMBER: 198320402
VISIT DATE: 07/24/2026
NARRATIVE
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interviews with R1-R10 regarding the allegation above. 9 of the 5 residents interviewed denied the allegation above and report that they (residents) and their POAs are made aware of any changes to their care plan. 1 of the 10 residents interviewed confirmed the allegation above and reported not being notified of any changes as they had a pendant placed on their wrist without explanation or consent. On 06/24/26 and 06/25/26 LPA conducted interviews with S1-S9 regarding the allegation above. 2 of the 9 staff interviewed denied the allegation above and reported that care plans are updated every 6 months or as needed due to a change in condition observed. 2 of the 9 staff also reported that POAs are notified of any changes being made to care plan and a conference is scheduled if POAs do not agree with the changes being made. 7 of the 9 staff interviewed reported having no knowledge of the allegation above. On 07/24/26 LPA conducted a review of R1's Admission agreement dated: 10/07/24. Per page 10 of 72, West Mall of Culver City will perform an assessment of your needs annually or as needed and will invite you and your family to participate at least annually and selecting and designing inappropriate care program for you. If Westmont of Culver City determines through an assessment that you require additional services or a different care Program then the one in which you are participating, you agree to the additional services or care program appropriate to your needs the rate for the new service or care program shall apply immediately. The community will give you written notice of a care change, and any correspondent rate increase within two business days after providing newly assessed services.

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.

Exit interview conducted, and a copy of this report was provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3