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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191202138
Report Date: 07/24/2025
Date Signed: 07/24/2025 11:40:10 AM

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 SOLFACILITY NUMBER:
191202138
ADMINISTRATOR:NANCY BISSONETTE-ANDREWFACILITY TYPE:
775
ADDRESS:9919 SUNLAND BOULEVARDTELEPHONE:
(818) 352-1419
CITY:SUNLANDSTATE: CAZIP CODE:
91040
CAPACITY:304CENSUS: 69DATE:
07/24/2025
UNANNOUNCEDTIME BEGAN:
11:16 AM
MET WITH:Maria JonesTIME COMPLETED:
11:17 AM
ALLEGATION(S):
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Clients in care engaged in inappropriate interactions
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Abeye Duguma visited the facility to reissue an addendum of the licensing reports previously delivered on 03/20/2025 and 07/18/2025.
The previous document delivered on 07/18/2025 was to change an initial outcome based on additional review and fact findings. This report is being reissued to make corrections to the previous document.
LPA met Maria Jones and explained the purpose of this visit.

It was alleged that client #1 (C1) entered the all-gender restroom where client #2 (C2) reached out and had inappropriate and unwanted interaction with C1.
To investigate the allegations above, LPA Antonia Alvizar conducted an initial visit 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 LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2025
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 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: 07/24/2025
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) verified that on 10/14/24 at 12:35pm C1 went into all gender restrooms. Upon going inside, female client C1 was touched on the buttocks area by the male client #2 (C2) who was already inside all gender restrooms. S2 walked inside the restroom a few seconds after C1 and witnessed C2's hand on C1's buttocks and C2's pelvic region pressed against C1's buttocks. S2 also heard C1 tell C2 "No, don't touch me. I don't like that!"
Client C2 saw S2 coming in and immediately removed their hand and pelvic area away from client C1.

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) 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 inspection, observations, interviews and record reviews, there is enough supporting information and evidence to verify the allegation. Therefore, the allegation is substantiated at this time.
The following citation is issued and recorded on LIC9099D.

No immediate health and safety hazard is noted during this viswit.

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: 07/24/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/24/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/24/2025
Section Cited
CCR
82078(a)
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82078 Responsibility for Providing Care and Supervision
(a) The licensee shall provide care and supervision necessary to meet the client's needs and all services specified in the admission agreement.
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Plan of correction was not issued as the facilty took preventative measures such as client one-to-one behavioral support and uses the single stall restrooms.
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This requirement is not met as evidenced by; Licensee did not ensure to provide required supervision to the clients using all gender bathrooms. C1 was inappropriately touched by C2 while using the bathroom.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:

DATE: 07/24/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3