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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191220719
Report Date: 04/08/2025
Date Signed: 04/08/2025 02:10:02 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
03/27/2025 and conducted by Evaluator Lorena Casillas
COMPLAINT CONTROL NUMBER: 31-AS-20250327150335
FACILITY NAME:BRU FAMILY HOME #2FACILITY NUMBER:
191220719
ADMINISTRATOR:LUIS BRUIFACILITY TYPE:
735
ADDRESS:528 EAST AVENUE J-10TELEPHONE:
(661) 949-6365
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY:6CENSUS: 4DATE:
04/08/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Marie BruTIME COMPLETED:
02:25 PM
ALLEGATION(S):
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Staff did not report an incident involving resident as necessary
INVESTIGATION FINDINGS:
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On 04/08/2025 at 10:00 am Licensing Program Analyst (LPA) Lorena Casillas conducted an unannounced subsequent complaint visit to investigate the above stated allegations. LPA was greeted and allowed entry by staff who proceeded to call Administrator/Licensee Marie Bru who met with LPA shortly after. LPA explained the reason for the visit. An entrance interview was conducted.

On 03/27/2025, the Woodland Hills South Adult and Senior Care Regional Office received a complaint regarding the allegations: Staff did not report an incident involving resident as necessary, Staff did not assist resident in a timely manner as necessary and, Staff did not seek medical assistance for resident as necessary.

On 04/02/2025 an initial visit was conducted by LPA Casillas. On that day LPA conducted tour of the facility, interviewed with facility staff, reviewed facility files and obtained copies of pertinent information related to the investigation. Continued on LIC9099-C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2025
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 6
Control Number 31-AS-20250327150335
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: BRU FAMILY HOME #2
FACILITY NUMBER: 191220719
VISIT DATE: 04/08/2025
NARRATIVE
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Allegation: Staff did not report an incident involving resident as necessary.

It is alleged that staff did not report an incident involving resident as necessary. Regarding this allegation it is reported that staff failed to report that Client #1 (C1) fell in a timely manner. Interview with Administrator revealed that C1 did not report any falls to Administrator. Administrator states that C1’s social worker visited C1 on 3/26/25 and that according to social worker C1 reported to social worker that C1 fell on 3/17/25 during the morning shower. Administrator states that same morning C1 had a doctor’s appointment, that Administrator took C1 to, and C1 did not report to provider either. Administrator states that C1 was not in any visible discomfort or pain. Administrator states that they sent in the SIR within the seven (7) days as required by Community Care Licensing (CCL), from the date of 3/26/25 when they were made aware of the alleged fall. LPA confirmed that SIR was sent in on 04/01/25 and 04/02/25. Administrator provided proof of fax confirmation with 4/02/25 as the date of when SIR was faxed to CCL. Interview with Staff #1 (S1) revealed that S1 was the staff on duty when C1 allegedly fell in the shower, however S1 states that they failed to report the fall to Administrator in a timely manner. S1 states that C1 fell in the shower however when C1 exited the shower C1 was not in any visible pain or distress and continued about their morning as usual. S1 admits to failing to report C1's fall due to forgetting. Interview with C1 revealed that C1 fell in the shower in the morning but that C1 did not report it to Administrator, nor did they report it to the provider that C1 saw that same day. Interview with two (2) additional staff revealed that a fall was not reported to them, however they did witness C1 limping when C1 returned later in the day from attending program. However, they did not report it to Administrator, they only wrote it on the daily log. Therefore, based on interviews, file review and observations this allegation is deemed substantiated.

Citation issued. Appeal rights discussed and provided. Exit interview conducted. Copy of report provided to Administrator.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 31-AS-20250327150335
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: BRU FAMILY HOME #2
FACILITY NUMBER: 191220719
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/08/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/18/2025
Section Cited
CCR
80061(b)(1)(D)
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80061(b)(1)(D) Reporting Requirements(b) Upon the occurrence, during the operation of the facility, of any of the events specified in (1) below(1) Events reported shall include the following (D) Any injury to any client which requires medical treatment. This was not met in evidence by:
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Licensee discussed and agreed to attending and having staff attend training on reporting requirements by POC due date. Proof will be emailed to LPA.
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Based on interviews and record review staff failed to report C1 falling on 3/17/25 in a timely manner, this poses a potential health and safety risk to clients in care.
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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: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 6
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
03/27/2025 and conducted by Evaluator Lorena Casillas
COMPLAINT CONTROL NUMBER: 31-AS-20250327150335

FACILITY NAME:BRU FAMILY HOME #2FACILITY NUMBER:
191220719
ADMINISTRATOR:LUIS BRUIFACILITY TYPE:
735
ADDRESS:528 EAST AVENUE J-10TELEPHONE:
(661) 949-6365
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY:6CENSUS: 4DATE:
04/08/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Marie BruTIME COMPLETED:
02:25 PM
ALLEGATION(S):
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Staff did not assist resident in a timely manner as necessary.
Staff did not seek medical assistance for resident as necessary.
INVESTIGATION FINDINGS:
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On 04/08/2025 at 10:00 am Licensing Program Analyst (LPA) Lorena Casillas conducted an unannounced subsequent complaint visit to investigate the above stated allegations. LPA was greeted and allowed entry by Administrator/Licensee Marie Bru, LPA explained the reason for the visit. An entrance interview was conducted.

On 03/27/2025, the Woodland Hills South Adult and Senior Care Regional Office received a complaint regarding the allegations: Staff did not report an incident involving resident as necessary, Staff did not assist resident in a timely manner as necessary and, Staff did not seek medical assistance for resident as necessary.

On 04/02/2025 an initial visit was conducted by LPA Casillas. On that day LPA conducted tour of the facility, interviewed with facility staff, reviewed facility files and obtained copies of pertinent information related to the investigation. Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 31-AS-20250327150335
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: BRU FAMILY HOME #2
FACILITY NUMBER: 191220719
VISIT DATE: 04/08/2025
NARRATIVE
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Allegation: Staff did not assist resident in a timely manner as necessary.

It is alleged that staff did not assist resident in a timely manner as necessary. Regarding this allegation it is reported that C1 fell in the shower, and that staff were not able to open bathroom door to assist C1 due to not finding the bathroom door key. Interview with Administrator denied the allegation stating that C1 did not report any falls to Administrator and that Administrator was made aware of the fall by C1’s social worker that visited C1 on 3/26/25 not on 03/17/25. Interview with S1 revealed that C1 did fall in the shower on 3/17/25, but that C1 had locked the bathroom door and S1 was not able to immediately get in. S1 stated that they were flustered and could not locate the keys, but that about five minutes later C1 was able to unlock the door and exit bathroom. S1 stated that C1 exited the bathroom and continued their morning as usual. S1 checked over C1 and there was no visible bruising or swelling noticed on C1 nor did C1 complain of any pain. Interview with C1 revealed that staff always assists C1 when C1 needs assistance however C1 did admit to not wanting help and refusing assistance. Interview with two (2) clients out of three (3) that were able to be interviewed revealed that staff always assist clients when they need assistance. Interviews with two (2) additional staff present revealed that C1 refuses assistance in the bathroom and does lock the door making it difficult for staff to get to C1 if there was a need to assist. Staff stated that the keys are always in the same area, in the staff room for all staff to have quick access. LPA was able to confirm that keys are located in the staff room. Therefore, based on interviews and observations this allegation is deemed unsubstantiated.

Continued on LIC9099-C

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 31-AS-20250327150335
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: BRU FAMILY HOME #2
FACILITY NUMBER: 191220719
VISIT DATE: 04/08/2025
NARRATIVE
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Allegation: Staff did not seek medical assistance for resident as necessary.

It is alleged that staff did not seek medical assistance for resident as necessary. Regarding this allegation it is reported that C1 fell, and staff did not seek medical attention after C1’s fall. Interview with Administrator revealed that they were not made aware by C1 or staff that C1 fell, however on the day that C1 fell, C1 had a podiatrist appointment and there was nothing noted by provider indicating there was an injury. When Administrator was made aware by C1’s social worker on 3/26/25 Administrator immediately arranged for C1 to be seen by a provider. Administrator was able to take C1 to medical provider on 3/27/25 and an x-ray referral of C1’s right ankle was ordered. Administrator denies the allegation stating that they sought medical attention as soon as they were made aware of the incident. Interview with two (2) out of three (3) clients that were able to be interviewed stated that Administrator is very involved with making sure that they always get medical assistance, and they have no issues with getting medical care. Interview with two (2) additional staff members revealed that Administrator is very involved with clients and that clients all receive medical attention when needed and medical/dental appointments are always made and kept on time. Interview with C1 revealed that C1 did see a doctor the same day as when they fell but that C1 did not report the fall to either Administrator or to provider because C1 was already being seen by provider. Therefore, based on interviews, record review and observations, this allegation is deemed Unsubstantiated.

Exit interview conducted. Copy of report provided to Administrator.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 6