191202138-7-18-2025-31-AS-NMAN-DK8PQG-20250804113102

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191202138
Report Date: 07/18/2025
Date Signed: 07/18/2025 01:45:16 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/16/2024 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20241016085352

FACILITY NAME:	TIERRA DEL SOL		FACILITY NUMBER:	191202138
ADMINISTRATOR:	NANCY BISSONETTE-ANDREW		FACILITY TYPE:	775
ADDRESS:	9919 SUNLAND BOULEVARD		TELEPHONE:	(818) 352-1419
CITY:	SUNLAND	STATE: CA	ZIP CODE:	91040
CAPACITY:	304	CENSUS: 69	DATE:	07/18/2025
		UNANNOUNCED	TIME BEGAN:	12:33 PM
MET WITH:	Lelani Dixon		TIME COMPLETED:	12:34 PM

ALLEGATION(S):

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Clients in care engaged in inappropriate interactions

INVESTIGATION FINDINGS:

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This is an addendum of the licensing report previously issued on 03/20/2025.
Upon further review of the investigation report and final findings, it was concluded that additional investigation may required which will reflect final outcome of the investigation.

---Clients in care engaged in inappropriate interactions

It was alleged that client #1 (C1) entered the all-gender restroom where client #2 (C2) reached out and had inappropriate interaction with C1.
To investigate the allegations above, LPA Antonia Alvizar conducted an initial visit at on 10/23/24 and requested copies of client and staff roster, staff contact information, clients (C1-C2) Identification and Emergency Information, T-Log, Individual Program Plan (IPP), Individual Support Plan (ISP), and additional information pertaining to the investigation.
(CONT on LIC 9099-C)

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20241016085352

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: TIERRA DEL SOL	FACILITY NUMBER: 191202138
	VISIT DATE: 07/18/2025

NARRATIVE

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During LPA De La Cerra's subsequent visit, on 3/20/25, staff interviews were conducted between 11:15am to 12:15pm, client interviews were conducted between 1:15pm to 2:15pm. At the time of this visit at 12:00p.m. LPA Duguma conducted physical plant inspection, which included the observation and inspection of all gender bathrooms.

At 12:10p.m. LPA Duguma conducted additional interviews with the staff that had knowledge of the incident involving C1 and C2.
interviews with staff #2 (S2) and Staff #3 (S3) revealed that on 10/14/24 at 12:35pm C1 went into all gender restrooms. Upon going inside, client C1 was touched on the buttocks area by another client #2 (C2) who was already inside all gender restroom. S2 walked inside the restroom a few seconds after client C1 and witnessed client C2's hand on client C1's buttocks and C2's pelvic region pressed against client C1's buttocks. Client C2 saw S2 coming in and immediately removed their hand and pelvic area away from client C1. S2 also heard client C1 tell client C2 "No, don't touch me. I don't like that!"

Interviews with facility staff, revealed that there are no previous incidents of C2 engaging in inappropriate behavior with C1, or act inappropriately towards another client. Staff revealed that none of them have observed client C2 engaging in inappropriate interactions with client C1 or with another client. Interviews with six (06) clients out of seven (07) clients revealed that they have never witnessed any clients engaging in inappropriate actions with another client nor have they been subjected to any inappropriate actions committed by them.

Record reviews reveal that C1 is able to use the restroom independently. Records also revealed that after the incident the facility implemented a preventive action plan and close supervision of C2. C2 was placed on one-on-one behavior support plan.

Based on observations, interviews and record reviews, there is enough supporting information and evidence to support the allegation. Therefore, the allegation is substantiated at this time. No citations or penalties issued.

Exit interview was conducted and a copy of the report was issued.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:	DATE: 07/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/18/2025

LIC9099 (FAS) - (06/04)

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