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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320404
Report Date: 06/02/2026
Date Signed: 06/02/2026 09:15:56 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, 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
05/19/2026 and conducted by Evaluator Troy Watson
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20260519082826
FACILITY NAME:NEW VILLA - MONARCHFACILITY NUMBER:
198320404
ADMINISTRATOR:VILLANUEVA, JENNIFERFACILITY TYPE:
740
ADDRESS:1638 E. CYRENE DRIVETELEPHONE:
(310) 844-9252
CITY:CARSONSTATE: CAZIP CODE:
90746
CAPACITY:6CENSUS: 3DATE:
06/02/2026
UNANNOUNCEDTIME BEGAN:
08:04 AM
MET WITH:ADMINISTRATOR - JENNIFER VILLANUEVATIME COMPLETED:
09:15 PM
ALLEGATION(S):
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Staff did not refund the preadmission fees to the applicant or the applicant’s representative.
INVESTIGATION FINDINGS:
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*This report does not supersede the previous report created on 05/26/2026 but is used to correct and clarify findings. *

On 06/02/2026 at approximately 08:04 AM Licensing Program Analyst (LPA) Watson conducted a subsequent complaint visit to the facility listed above to deliver findings. LPA Watson met with Care Giver Raffy Miranda and explained the reason for the visit. LPA Watson was granted entry into the facility.

The investigation consisted of the following: On 05/26/2026 between 12:30 PM – 04:50 PM, the Department requested, obtained, and reviewed the following records: Resident Roster dated 05/10/2026, Staff Roster dated 01/02/2025, Short-Term Respite Admission Agreement dated 04/20/2026, Medical Assessments dated 03/04/2026, 04/20/2026, and 05/03/2026, and the Immunization Record for R1 dated 03/16/2026.

CONTINUE ON LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2026
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-20260519082826
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: NEW VILLA - MONARCH
FACILITY NUMBER: 198320404
VISIT DATE: 06/02/2026
NARRATIVE
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The Department conducted interviews with Staff #1–#3 (S1–S3) and Residents #2–#3 (R2–R3). An attempt to interview R1 was made; however, R1 could not be reached via telephone and was not at the facility at the time of the visit.

Allegation: Staff did not refund the pre-admission fees to the applicant or the applicant’s representative.

It is alleged that the facility declined to issue a refund despite multiple requests for reimbursement to the applicant or the applicant’s representative based on services never rendered.
On 05/26/26 between 12:30 AM and 04:50 PM, the Department conducted an interview with S1. During the interview, S1 was asked if the facility refunded the pre-admission fees to the applicant or the applicant’s representative. S1 answered that the facility does not charge pre-admission fees but instead has a respite agreement that mentions refunding 75% of the unused portion of the monthly payment and that refunds are only provided in the event of a resident’s passing. S1 was also asked to describe the payments received for the stay and explain how those payments were recorded or processed. S1 stated that upon signing the contract, the reporting party issued a check for the first week, which serves as the holding agreement for a room. S1 also stated that it is indicated in the agreement that if the resident’s responsible party decided not to use the room after paying for the first week, even if the resident did not occupy the room, they would not receive a refund unless the resident passed away.

On 05/26/2026 between 12:30 AM and 04:50 PM the Department conducted interviews with Staff #1–#3 (S1–S3) and Residents #2-3 (R2-R3). Out of those interviewed 3 out of 3 staff and 2 out of 3 residents denied the above allegation. An attempt to interview Resident#1 was made but R1 was not at the facility at the time of visit. On 05/26/2026 between 12:30 AM and 04:50 PM, the Department obtained and reviewed the Short-Term Respite Admission Agreement dated 04/20/2026, and it showed on page 1 under “Purpose of Stay” that the resident was being admitted for a temporary short-term respite stay from 05/18/2026 to 06/01/2026. Further review of the Short-Term Respite Admission Agreement showed on page 2, No. 5 under “Rate and Payment Terms,” that a refund of the unused portion of 75% will be returned to the family within 14 days and that refunds are only provided for the passing of a resident prior to a respite visit. The department reviewed the Short-Term Respite Admission Agreement and observed that it was signed on 04/20/2026 by R1’s responsible person.

CONTINUED ON LIC9099-C
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 11-AS-20260519082826
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: NEW VILLA - MONARCH
FACILITY NUMBER: 198320404
VISIT DATE: 06/02/2026
NARRATIVE
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Based on the information gathered, interviews conducted, and an analysis of records reviewed, the Department found no evidence to support the allegation mentioned above. 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 Jennifer Villanueva, and a copy of this report was provided.
SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Troy Watson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/02/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3