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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602639
Report Date: 09/14/2026
Date Signed: 09/14/2026 04:23:17 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/10/2026 and conducted by Evaluator Bonnie Tao
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260910105419
FACILITY NAME:D & L RESIDENTIAL CARE HOME 2FACILITY NUMBER:
198602639
ADMINISTRATOR:RAFAEL DIAZFACILITY TYPE:
740
ADDRESS:1036 S. BARRANCA AVENUETELEPHONE:
(562) 774-7167
CITY:GLENDORASTATE: CAZIP CODE:
91740
CAPACITY:6CENSUS: 5DATE:
09/14/2026
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Staff Markjohn SalongaTIME COMPLETED:
04:15 PM
ALLEGATION(S):
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Staff did not observe change in resident's health in a timely manner.
Staff did not seek medical attention to a resident in a timely manner.
Resident sustained hospitalization due to staff neglect.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tao conducted an unannounced complaint investigation visit regarding the above allegations. The purpose of the visit was discussed with staff Markjohn Salonga and Administrator Ralph Estanislao over the phone.

The investigation consisted of:
LPA conducted an investigation, which consisted of four (4) resident interviews, three (3) staff interviews, physical plant tour, and facility records reviews of the obtained records including:
1. Staff roster and Resident roster,
2. Residentt#1 (R1)’s Admission Agreement, dated 07/11/2026 and Face sheet.
3. R1’s Physician’s Report, dated 07/09/2026.
4. R1’s Pre-placement Appraisal, dated 7/11/2026.
5. R1’s Home Health Admission Records dated 7/18/2026 and 09/09/2026.
6. R1’s Unusual Incident Report, dated 09/06/2026. (-continued on LIC 9099C-)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Bonnie Tao
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2026
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 4
Control Number 28-AS-20260910105419
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: D & L RESIDENTIAL CARE HOME 2
FACILITY NUMBER: 198602639
VISIT DATE: 09/14/2026
NARRATIVE
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The investigation revealed:

Regarding allegation: Staff did not observe change in resident’s health in a timely manner. It was alleged that staff did not notice a resident’s foley catheter was not being changed for approximately two months and resulted in the resident’s health condition being changed. Per the resident interviews, one (1) resident was sleeping when LPA attempted to conduct interview. One (1) out of five (5) residents interviewed was unable to comprehend the interview questions. Three (3) out of five (5) residents interviewed did not corroborate with the allegation. Per staff interviews, all three (3) out of three (3) staff interviewed did not corroborate the allegation. The Administrator Ralph Estanislao indicated the resident’s previous Home Health Agency did not change resident’s foley catheter from all of their visits since July 2026. The Administrator discussed it with the resident’s family and encouraged the family to change the home health to another agency. Per record review of Home Health Admission Records, resident’s Home Health Nurse was responsible for changing resident’s foley catheter weekly. As stated in the incident report, facility staff reported that they had observed the resident’s condition changes, reported them to the Administrator and, as a result, called 911 for the resident timely. Per LPA’s observation during the visit, the resident did not have foul odor but looked clean and able to carry on a coherent conversation during the interview. The investigation did not reveal evidence that staff did not observe changes in resident’s health in a timely manner.

Regarding allegation: Staff did not seek medical attention to a resident in a timely manner. It was alleged that staff did not provide adequate Home Health care follow-up visit. Per the resident interviews, one (1) resident was sleeping when LPA attempted to conduct interview. One (1) out of five (5) residents interviewed was unable to comprehend the interview questions. Three (3) out of five (5) residents interviewed did not corroborate with the allegation. Per staff interviews, all three (3) out of three (3) staff interviewed did not corroborate the allegation. Staff indicated they had contacted the resident’s previous Home Health Agency multiple times via phone calls, text messaging and in-person discussion with the Home Health nurses during their visits. Staff was aware of the resident’s needs for Home Health follow-up visits to change residents’ foley catheter.
(-continued on LIC 9099C-)
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Bonnie Tao
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 28-AS-20260910105419
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: D & L RESIDENTIAL CARE HOME 2
FACILITY NUMBER: 198602639
VISIT DATE: 09/14/2026
NARRATIVE
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However, the nurses from the previous Home Health agency would visit the resident on random days or no-show for the last two months. Therefore, the Administrator brought to the resident’s family’s attention regarding the resident’s medical needs and advised them to change Home Health Agency to another one. Per record review, the resident’s previous Home Health agency did not document any foley catheter changes for the resident during visits, and no follow-up visit was scheduled after each visit. Thus, the resident’s Home Health Agency did not provide adequate services to the resident. The investigation did not reveal evidence that the facility staff did not seek medical attention to a resident in a timely manner.

Regarding allegation: Resident sustained hospitalization due to staff neglect. It was alleged that resident was hospitalized because staff did not schedule home health visits and did not change a resident’s Foley Catheter for approximately two months. Per the resident interviews, one (1) resident was sleeping when LPA attempted to conduct interview. One (1) out of five (5) residents interviewed was unable to comprehend the interview questions. Three (3) out of five (5) residents interviewed did not corroborate with the allegation. Per staff interviews, all three (3) out of three (3) staff interviewed did not corroborate the allegation. Per record review, the Home Health Nurses were responsible for changing the resident’s catheter tube. As mentioned above, staff stated they reached out to the resident’s previous Home Health Agency multiple times and requested medical assistance to change resident’s catheter tube and follow up visits. However, all of their attempts were not successful. Staff were aware of the resident’s changes in medical condition and suggested the resident’s responsible party to call 911. As the end, the resident’s responsible party consented to call 911. The investigation did not reveal evidence that a resident sustained hospitalization due to staff neglect.

Based on the information obtained during the investigation, interviews with staff, residents, review of resident files and LPA's observation, the investigation did not reveal any evidence to support the allegations mentioned above.

(-continued on LIC 9099C-)
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Bonnie Tao
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 28-AS-20260910105419
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: D & L RESIDENTIAL CARE HOME 2
FACILITY NUMBER: 198602639
VISIT DATE: 09/14/2026
NARRATIVE
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Although the allegations may have happened or are valid, there is no preponderance of evidence to prove the alleged violations did or did not occur, therefore, the allegations are UNSUBSTANTIATED.

An exit interview was conducted with staff Markjohn Salonga. The findings were discussed and a copy of this report was provided.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Bonnie Tao
LICENSING EVALUATOR SIGNATURE:

DATE: 09/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 4