191202138-7-18-2025-31-AS-NMAN-DK8R6P-20250804124503

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191202138
Report Date: 07/18/2025
Date Signed: 07/18/2025 01:46:10 PM

Unsubstantiated

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
07/10/2024 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20240710140951

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:	12:49 PM
MET WITH:	Leilani Dixon, Program Director		TIME COMPLETED:	12:50 PM

ALLEGATION(S):

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Client sustained multiple unexplained injuries while in care

INVESTIGATION FINDINGS:

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This is an addendum of the previous Licensing Report issued on 03/20/2025.
Licensing Program Analyst (LPA Abeye Duguma conducted unannounced subsequent visit to the facility. The purpose of this visit was to obtain additional information to support final findings of the allegation.

Regarding the allegation: Client sustained multiple unexplained injuries while in care.
It has been alleged that non-verbal client #1 (C1) who attends the day program came home with bruises on two separate occasions, 7/01/24 and 7/08/24.

To investigate the allegation, LPA Leizl DeLaCerra conducted an initial visit on 7/16/24. LPA requested copies of facility documents included but not limited to client’s records, client and staff roster, facility program plan, internal incident log etc.
(CONT. on LIC 9099-C)

Unsubstantiated

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-20240710140951

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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LPA conducted interviews with staff 1(S1) and staff 2 (S2), staff 3 (S3), staff 4 (S4) and other witnesses, including bus drivers and Consumer Services Coordinator (CSC) from North Los Angeles Regional Center (NLARC).

At the time of this visit at 11:00a.m. LPA Duguma conducted additional interviews with facility staff and at 12:30p.m. gathered additional documents.
Interviews with S1 and S2 confirms that C1 is attending a workforce development program, which is an in-person volunteer job, five times a week. C1 belongs to a developmental program that consists of only three (3) clients including C1 and there are no incidents or records of the other two (2) clients injuring C1.
C1’s customized routine starts out with being dropped off at Tierra Del Sol day program by R&D Transportation which is an approved vendor for (NLARC) and was not affiliated with Tierra Del Sol. R&D transportation is responsible for transporting C1 from C1’s residence to the day program in the morning and back to C1’s residence in the afternoon. Interviews with R&D transportation personnel, W1,W2 and W3 revealed that no one witnessed C1 getting physically assaulted and one can confirm how C1 sustained injuries while on the bus during those specific dates of 7/1/24 and 7/8/24. Per LPA observation R&D transportation buses are not equipped with any video surveillance camera that could have provided footage for the investigation.
LPA’s review of records reveals that on 6/04/24 another client #2 (C2) admitted to a program manager, S4 that C2 physically assaulted C1 while both C1 and C2 were onboard the bus. Interviews with staff revealed that they spoke with the bus driver and other clients on the bus that morning of 6/04/24 and no one witnessed C2 hitting C1.
Records revealed that corrective actions were implemented for C2 by staff member S4, to prevent C2 from harming other clients on the bus. These corrective actions were addressed with R&D transportation. However, R&D Transportation did not comply with the corrective actions implemented by the facility staff. No incidents were recorded for 07/01/24 or 07/08/24.

Based on record reviews, observations, interviews with staff and other witnesses, although the incidents may have occurred, there is no sufficient information or evidence to verify the validity of the complaint.
Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Exit interview was conducted and a copy of 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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