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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603457
Report Date: 07/07/2026
Date Signed: 07/07/2026 04:03:09 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
06/30/2026 and conducted by Evaluator Elena Mallett
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20260630125713
FACILITY NAME:AYANNA HOME CAREFACILITY NUMBER:
198603457
ADMINISTRATOR:MATE, KELVINFACILITY TYPE:
740
ADDRESS:5602 WHITEWOOD AVETELEPHONE:
(562) 232-3034
CITY:LAKEWOODSTATE: CAZIP CODE:
90712
CAPACITY:6CENSUS: 5DATE:
07/07/2026
UNANNOUNCEDTIME BEGAN:
08:04 AM
MET WITH:Administrator- Elba RodriguezTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff did not ensure resident's privacy was protected
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elena Mallett conducted an unannounced complaint investigation in response to the above allegation. LPA met with Administrator Elba Rodriguez and explained the purpose of the visit.
On today’s visit the investigation included LPA interviews with Licensee’s family member, five (5) staff including the Administrator and five (5) residents. LPA collected a current staff and resident roster and reviewed video footage provided by Reporting Party (RP). LPA conducted a tour of the facility and did not observe any immediate health and/or safety concerns.
Regarding the allegation staff did not ensure resident's privacy was protected: It is alleged that staff at the facility are revealing personal and confidential information about a resident’s ethnicity, weight and medical condition on social media platforms. The Licensee’s family member was interviewed and denies this allegation. Five (5) out of five (5) staff interviewed, including the Administrator, deny this allegation. Three (3) out of five( 5) residents interviewed deny this allegation. Two (2) of (5) residents interviewed could not provide feedback to LPA’s questions due to cognition issues.

Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Elena Mallett
LICENSING EVALUATOR SIGNATURE:

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

DATE: 07/07/2026
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 2
Control Number 28-AS-20260630125713
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: AYANNA HOME CARE
FACILITY NUMBER: 198603457
VISIT DATE: 07/07/2026
NARRATIVE
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LPA reviewed video footage provided by Reporting Party (RP) of a social media platform on which Licensee’s family member appeared. In the video footage Licensee’s family member was heard by LPA to be describing an individual, however, LPA did not observe any resident during LPA’s visit to Ayanna Home Care that fit the description heard in the video. During LPA’s interview with Licensee’s family member it was revealed that this family member does participate in live stream social media platform panels. Per Licensee’s family member, topics of discussion on these panels are related to how to operate a business and to current events. Confidential and personal information of Ayanna Home Care residents is never discussed by Licensee’s family member during these panels or by Licensee’s family member on any other social media platform. Five ( 5) out five (5 )staff members at Ayanna Home Care including the Administrator, state residents’ private and confidential information is protected and only discussed by staff as it relates to providing resident care and is never shared on social media. Five(5) out of five (5) staff members including the Administrator state the Ayanna Home Care and its residents are not discussed or depicted in any way on staffs’ personal social media platforms. Five(5) out five(5) staff and Administrator deny being aware of Licensee's family member's activity on social media platforms. Five (5) out (5) staff including Administrator state staff are trained upon hire with regards to ensuring resident privacy is protected and personal rights. The three residents able to provide feedback to LPA regarding the allegation all state the staff protect resident's private and confidential information and do not release resident private and confidential information on social media platforms. The investigation did not reveal that a resident’s private, confidential information was shared on a social media platform by staff or Licensee’s family member. The investigation revealed that staff do ensure that resident’s privacy is protected.

Based on LPA interviews with staff, residents and Licensee’s family member and LPA’s observations there was not enough supportive evidence to concur with the reported allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

An exit interview was conducted with Administrator Elba Rodriguez and a copy of this Licensing report was provided.

SUPERVISORS NAME: Fernando Fierros
LICENSING EVALUATOR NAME: Elena Mallett
LICENSING EVALUATOR SIGNATURE:

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

DATE: 07/07/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2