198204848-5-2-2026-11-AS-SCIS-DVBUPH-20260623154535

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198204848
Report Date: 04/28/2026
Date Signed: 05/02/2026 02:19:10 AM

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
12/24/2025 and conducted by Evaluator Pamela Bunker

COMPLAINT CONTROL NUMBER: 11-AS-20251224093938

FACILITY NAME:	PLD FAMILY HOME CARE		FACILITY NUMBER:	198204848
ADMINISTRATOR:	PRECIOUS DENNIS		FACILITY TYPE:	740
ADDRESS:	139 WEST ELLIS AVENUE		TELEPHONE:	(310) 419-5829
CITY:	INGLEWOOD	STATE: CA	ZIP CODE:	90302
CAPACITY:	6	CENSUS: 6	DATE:	04/28/2026
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Precious Dennis		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff prevented the resident from being assessed by their healthcare provider.
Staff prevented the resident from receiving a visitation.

INVESTIGATION FINDINGS:

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On April 28, 2026, at 8:00 a.m., Licensing Program Analyst (LPA) Pamela Bunker conducted a subsequent visit to gather information regarding the above allegations. LPA met with Precious Dennis, Administrator, and explained the purpose of the visit. LPA was granted entry to the facility.

The investigation consisted of the following: On December 30, 2025 and January 23, 2026, the following documents were reviewed and obtained as part of the investigation: Personnel Report (dated 12/30/2025), Resident Roster (dated 12/30/2025), Admission Agreement (dated 07/01/2024), Identification and Emergency Information (dated 07/01/2024), Physician’s Report (dated 06/27/2024), Medical Assessment (dated 06/27/2024), Medication Administration Records (MARs) (dated 12/01/2025-12/31/2025), Resident Appraisal & Needs and Services Plan (dated 07/01/2024), Functional Capability Assessment (dated 08/01/2025 & 12/29/2025), Preplacement Appraisal Information (dated 07/01/2024), Personal Rights (dated 07/01/2024), Consent Forms (dated 07/01/2024), Durable Power of Attorney (dated 08/15/2023, 08/16/2023, and 08/18/2023) Healthcare Agent and Notary Public (dated 07/10/2023), See continued LIC9099-C page 2.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2026

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-20251224093938

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: PLD FAMILY HOME CARE	FACILITY NUMBER: 198204848
	VISIT DATE: 04/28/2026

NARRATIVE

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Continued LIC9099-C page 2.

Ring Doorbell Video Camera (dated 12/05/2025), Text Messages (12/01/2025--12/03/2025), and Sign-In and Sign-Out Sheet (dated 12/01/2025-12/31/2025).

On 12/29/2025, between 9:00 a.m. and 3:15 p.m., LPA Pamela Bunker conducted interviews with staff members #1–#2 (S1–S2) and residents #1–#4 (R1–R4).

The investigation revealed the following:

Allegation: Staff prevented the resident from being assessed by their healthcare provider.
LPA interviewed S1-S2. Both staff members (2 out of 2) stated that the staff did not prevent the resident from being assessed by their healthcare provider. S1-S2 stated that Resident 1 (R1) has a durable Power of Attorney (POA), with one individual responsible for financial decisions and another responsible for medical decisions. S1-S2 stated that the facility has no authority or control over the resident’s healthcare or the selection of healthcare providers. Decisions regarding medical assessments are solely determined by the POA for medical decisions, not the facility. R1-R2 stated that the facility has a visitors logs, that show a nurse comes to the facility every week. Both staff members, S1 and S2, denied the allegation.

LPA Bunker interviewed Residents #1–#4 (R1–R4), 4 out of 4 residents stated that staff do not prevent residents from being assessed by their healthcare provider. Resident #1 (R1) stated that they have a durable power of attorney that makes decisions on their behalf because they are unable to make decisions independently. R1-R4 denied the allegation.

LPA Bunker interviewed Witness #1 (W1), who confirmed that they are the Power of Attorney (POA) for Resident #1 (R1) and make all healthcare decisions, not the facility. W1 stated that they arranged for a nurse to visit the facility twice a week and for the physician to visit every two months to provide care for R1. W1 denied the allegation.

See continued LIC9099-C page 3.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20251224093938

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: PLD FAMILY HOME CARE	FACILITY NUMBER: 198204848
	VISIT DATE: 04/28/2026

NARRATIVE

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Continued LIC9099-C page 3.

Allegation: Staff prevented the resident from receiving a visitation.
LPA Bunker interviewed staff members #1 and #2 (S1–S2). Both staff members (2 out of 2) stated that residents are not prevented from receiving visitations. 2 out of 2 staff members stated that visiting hours are scheduled daily from 11:00 a.m. to 7:00 p.m., and reported that all residents are allowed visitors during these hours and confirmed that staff do not restrict or interfere with visitations. 2 out of 2 staff members stated that the facility maintains a Visitor Sign-In and Sign-Out sheet to document all visits, and the logs confirm that R1 is receiving visitors. Staff reported that they have never denied visitors access to the residents. S1-S2 denied the allegation.

LPA Bunker interviewed Residents #1–#4 (R1–R4). All four residents (4 out of 4) stated that staff do not prevent residents from receiving visitors and confirmed that their family members visit regularly during designated visiting hours. R1–R4 denied the allegation.

LPA Bunker also interviewed Witness #1 (W1), who stated that they were the Power of Attorney (POA) for medical decisions. W1 stated that R1 is not denied visitation and can receive visitors at the facility. W1 also stated that R1 is permitted to leave the facility for outings and off-site visits with family. W1 denied the allegation.

Based on interviews, available evidence, observation, information received, and records reviewed there was not enough evidence to support the allegations. 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 deemed unsubstantiated.

There were no deficiencies cited. LPA Bunker provided Administrator Precious Dennis with copies of the Complaint Investigation Reports LIC-9099 and LIC-9099Cs. An exit interview was conducted.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 04/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/28/2026

LIC9099 (FAS) - (06/04)

Page: 3 of 3