198320402-9-23-2026-11-AS-PMAA-DYWNKM-20261016103209

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320402
Report Date: 09/23/2026
Date Signed: 09/23/2026 02:34:54 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 CITY		FACILITY NUMBER:	198320402
ADMINISTRATOR:	DAWN M SMITH		FACILITY TYPE:	740
ADDRESS:	11141 WASHINGTON BLVD		TELEPHONE:	(310) 736-4118
CITY:	CULVER CITY	STATE: CA	ZIP CODE:	90232
CAPACITY:	160	CENSUS: 147	DATE:	09/23/2026
		UNANNOUNCED	TIME BEGAN:	01:31 PM
MET WITH:	Executive Director Dawn Smith		TIME COMPLETED:	02:45 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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This report supercedes report dated: 07/24/26, this report does not change complaint findings, LPA is correcting grammer errors.

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 conducted interviews with residents # 1-0 (R1-R10). On 07/24/26 LPA conducted a review of documents obtained for R1,

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026

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: 09/23/2026

NARRATIVE

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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.

It is alleged that resident in care was bitten on neck and arm by bed bugs. On 06/24/26 and 06/25/26 LPA conducted interviews with S1-S9 regarding the allegation above. 5 of the 9 staff interviewed confirmed the allegation and reported observing bedbugs at the facility. 4 of the 9 staff denied the above allegation and reported not observing bedbugs at the facility. 9 of 9 staff reported pest control services came out to the facility. On 06/25/26 and 07/24/26 LPA conducted interviews with R1-R10 regarding the allegation above. 8 of 10 residents denied the allegation above. 2 of 10 residents reported they have not seen the bedbugs, but it was reported by their caregiver. 9 of 10 residents report they have not been bitten by any bedbugs, insects, or spiders. 1 of 10 residents reported being bitten by bedbugs. 10 of 10 residents reported pest control service services are done at the facility. On 07/24/26 LPA conducted a review of Orkin service reports the following were observed: Orkin service report 06/01/26 1 unit on 3rd floor inspected for bedbugs and 10 live bedbugs were observed and treated per scope. Orkin service report dated 06/16/26 canine inspection was conducted for units on 3 units and third floor hallway no bedbug life found. 07/22/26 canine inspection was conducted and no activity was observed. LPA observed that Westmont of Culver City paid for all pest control services conducted at the facility.

Allegation: Staff did not conduct an accurate appraisal of resident in care.

It is alleged that facility staff updated a resident’s care plan without a documented change in condition to justify the update. On 06/25/26 and 07/24/26 LPA conducted interviews with R1-R10 regarding the allegation above. 9 of the 10 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 conditions observed. 2 of the 9 staff also reported that POAs are notified of any changes being made to a care plan and a conference is scheduled if the POA does not agree with the changes being made. 7 of the 9 staff interviewed reported having no knowledge of the above allegation. Furthermore, 1 of the 9 staff interviewed stated that R1 was reassessed on 03/15/26 due to a noted blister and R1 was again reassessed on 03/18/26. Per the 1 of the 9 staff interviewed, the points in care did increase for R1 but there was no change

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026

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: 09/23/2026

NARRATIVE

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in cost of care, and POA was emailed a copy of updated care plan. On 07/24/26 LPA conducted a review of R1's Admission agreement dated: 10/07/24. Per page 10 of 72, Westmont 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 in selecting and designing an appropriate 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: 09/23/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2026

LIC9099 (FAS) - (06/04)

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