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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198601704
Report Date: 05/29/2026
Date Signed: 05/29/2026 03:42:39 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
05/21/2026 and conducted by Evaluator Regina Cloyd
COMPLAINT CONTROL NUMBER: 11-AS-20260521164025
FACILITY NAME:HARMONY HOME CAREFACILITY NUMBER:
198601704
ADMINISTRATOR:DIONSIO, ANTONIAFACILITY TYPE:
740
ADDRESS:1318 215TH STREETTELEPHONE:
(310) 549-0218
CITY:CARSONSTATE: CAZIP CODE:
90745
CAPACITY:6CENSUS: 3DATE:
05/29/2026
UNANNOUNCEDTIME BEGAN:
08:23 AM
MET WITH:Susana ParungaoTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff locked resident in the room.
Staff do not properly prepare resident(s) meal.
Staff do not provide resident with medical attention.
INVESTIGATION FINDINGS:
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On 05/29/2026, Licensing Program Analyst (LPA) Regina Cloyd conducted an initial visit to gather information regarding the above allegations. LPA met with Staff and spoke with Administrator Antonia Dionsio over the phone.

Investigation consisted of the following: On 05/29/2026, the Department obtained Resident #1 - #4 (R1 – R4) records, Resident #1 and #2 Medication Administration Record (April and May 2026) and interviewed Staff #1 - #3 (S1 – S3), Residents #3 - #4 (R3 – R4), and Witness #1 (W1).

Investigation revealed the following:
Allegation: Staff locked resident in the room.
It is alleged staff tied a rope outside of the Resident #2’s (R2) door to prevent R2 from getting out and lock R2 in room. Record Review of R2’s Physician's Report (10/15/25) revealed R2's primary diagnosis is dementia with behaviors (disturbances), has a walker... Continue to LIC9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026
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-20260521164025
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: HARMONY HOME CARE
FACILITY NUMBER: 198601704
VISIT DATE: 05/29/2026
NARRATIVE
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,can be confused/disoriented and have sundowning behavior. Review of Needs and Services Plan (10/10/25) revealed R2 is forgetful, can be agitated, and like a zombie at night. Staff is to keep reminding R2. R2 will not walk if R2 doesn’t like but if R2 likes to walk then staff cannot stop R2. The goal is for staff to help R2 walk and exercise every day. Three out of three staff interviews (S1 – S3) indicated they have not locked R2 in room. Two out of two residents (R3 – R4) indicated they are allowed to wander and move around the facility. R4 indicated R4 has not seen a rope tied outside of R2’s door and hears the staff run to R2 when R2 gets up. Witness #1 (W1), R2’s family member, indicated that the door is always open and denied the allegation. At 8:23 AM, LPA observed staff pushing R2 outside in walker.

Regarding the allegation, “Staff locked resident in the room,” based on record review, interviews, and observation, the Department found no evidence to support the above allegation. The allegation may have happened or is valid, but there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the allegation is Unsubstantiated.

Allegation: Staff do not properly prepare resident(s) meal.
It is alleged staff put chicken bones in Resident #1’s (R1) soup and casserole
Record Review of Preplacement Appraisal (03/16/26) revealed R1 needs a soft food diet. Three out of three staff members indicated they consider the cultural and religious background and food habits of the residents. Staff #1 indicated the chicken is shredded and sometimes a bone may remain, but it is soft. Staff #2 indicated S2 has not received food (bone) complaints from R1. Staff #3 indicated bones are removed from the chicken soup. Two out of two resident interviews (R3 – R4) indicated an appropriate variety of foods with consideration for cultural and religious background and food habits is provided. Witness #1 (W1) indicated an appropriate variety of foods with consideration for cultural and religious background and food habits are provided for R2.

Regarding the allegation, “Staff do not properly prepare resident(s) meal,” the Department found no evidence to support the above allegation. The allegation may have happened or is valid, but there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the allegation is Unsubstantiated.

Continue to LIC9099-C.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 11-AS-20260521164025
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: HARMONY HOME CARE
FACILITY NUMBER: 198601704
VISIT DATE: 05/29/2026
NARRATIVE
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Allegation: Staff do not provide resident with medical attention.
It is alleged staff would not assist Resident #1 (R1) and told R1 not to call 911. Three out of three staff members (S1 – S3) indicated they assist R1 with back pain and have not prevented R1 from calling emergency services. Staff #1 (S1) indicated emergency services would get upset with pain complaints but R1 has own cellphone and it is R1’s personal right. Staff #2 (S2) indicated R1 would call emergency services when S2 would not administer additional Lorazepam or when R1 could not feel the effect of the medication. S2 indicated S2 would accompany R1 outside and wait for emergency services. Two out of two resident interviews (R3 – R4) indicated staff provide or will seek medical attention when needed. Witness #1 (W1) indicated staff provide or will seek medical attention when R2 needs it.

Regarding the allegation, “Staff do not provide resident with medical attention,” the Department found no evidence to support the above allegation. The allegation may have happened or is valid, but there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the allegation is Unsubstantiated.

An exit interview was conducted and a hard copy was provided to Staff Susana Parungao.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2026
LIC9099 (FAS) - (06/04)
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