Complaint Investigation Report

157209425-11-4-2025-24-AS-SMOA-DNDLYF-20251113081014

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

This is an official report of an unannounced visit/investigation of a complaint received in our office on

10/29/2025 and conducted by Evaluator Mai Yang

COMPLAINT CONTROL NUMBER: 24-AS-20251029100138

Licensee/Administrator Lina Juarez and Licensee Shervin Mohammadi

Staff did not treat resident with respect

On this date, Licensing Program Analyst (LPA) M. Yang conducted initial complaint investigation. LPA introduce self, stated the purpose of the visit, and met with Licensee/Administrator (L1) Lina Juarez. Licensee (L2) Shervin Mohammadi arrived shortly. LPA discussed complaint and delivered complaint findings to Licensees.

During the course of the investigation, the Department conducted interviews and reviewed records. L1 confirmed making comments regarding R1. Based on interviews conducted, staff alleged not treating resident with respect, the preponderance of evidences has been met. Therefore, the above allegation is found to be SUBSTANTIATED. An exit interview was conducted. A copy of this report and appeal rights were provided to Licensee/Administrator, whose signature on this form confirms receipt of this report.