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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191222593
Report Date: 03/17/2023
Date Signed: 03/17/2023 01:29:12 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
03/16/2023 and conducted by Evaluator Jose Gary Tan
COMPLAINT CONTROL NUMBER: 31-AS-20230316141801
FACILITY NAME:COMMUNICATION IMPROVEMENT GUIDANCE CENTERFACILITY NUMBER:
191222593
ADMINISTRATOR:AGBEDE, SONNYFACILITY TYPE:
735
ADDRESS:15030 SEPTO STREETTELEPHONE:
(818) 891-6555
CITY:MISSION HILLSSTATE: CAZIP CODE:
91345
CAPACITY:6CENSUS: 4DATE:
03/17/2023
UNANNOUNCEDTIME BEGAN:
09:22 AM
MET WITH:Shonibare "Inka" Olayinka - StaffTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Lack of Staff
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Gary Tan conducted an unannounced initial complaint visit at this facility to investigate the above allegation. LPA met with staff Shonibare Olayinka who called the administrator Sonny Agbede and explain the reason for the visit. Mr. Agbede designated Ms. Olayinka to sign the report.

LPA conducted physical plant tour at 9:38 AM, requested copy of facility documents relevant to investigation at 10:00 AM and interviewed staff between 10:15 AM to 12:00 PM. It was alleged that there was no general staffing in the morning of 02/16/23, all staff where on 1:1 with residents. LPA's record review today revealed that there were two (2) agency staff present during the credible witness' visit on 02/16/23. The only facility organic staff on duty drove another resident at the day program. LPA's interview with Mr. Agbede today at 10:30 AM revealed that there was indeed no general staff on duty at that time because they were short staff due to the suspension of two (2) of his staff, he however put in place another staff immediately to cover when called upon by the North Los Angeles Regional Center staff . (continued on LIC 9099-C)

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
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-20230316141801
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: COMMUNICATION IMPROVEMENT GUIDANCE CENTER
FACILITY NUMBER: 191222593
VISIT DATE: 03/17/2023
NARRATIVE
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(continued from LIC 9099)

LPA's interview with staff today at 11:40 AM confirmed that there was no general staff at that time and the facility staff who drove another resident to the day program was the only organic staff of the facility on duty but the staff's duty was also on one on one basis.

Based on the information gathered during this visit, the allegation is deemed substantiated at this time.

Citation issued. Appeal rights discussed and given.

Exit interview conducted. Copy of this report issued.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20230316141801
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: COMMUNICATION IMPROVEMENT GUIDANCE CENTER
FACILITY NUMBER: 191222593
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/17/2023
Section Cited
CCR
85065.5(a)(1)
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(1) For Regional Center clients, staffing shall be maintained as specified by the Regional Center but no less than one direct care staff to three such clients.

This requirement is not met as evidenced by:
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Cleared during visit. Administrator immediately placed another staff to cover for the general staff per the credible witness.
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Based on credible witness' observation on 02/16/23, the licensee failed to ensure that the staff is sufficient at the facility per agreed schedule, this poses a potential personal rights & health and safety risk to the residents 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: Naira Margaryan
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3