195850090-6-5-2026-29-AS-KLOZ-DWHV6D-20260731160923

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 195850090
Report Date: 06/05/2026
Date Signed: 06/05/2026 02:50:54 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/13/2026 and conducted by Evaluator Sandra Urena

COMPLAINT CONTROL NUMBER: 29-AS-20260213100640

FACILITY NAME:	SUNSHINE RESIDENTIAL HOME BALBOA		FACILITY NUMBER:	195850090
ADMINISTRATOR:	JOSE, OYINLOYE AUSTINE		FACILITY TYPE:	735
ADDRESS:	7431 JELLICO AVENUE		TELEPHONE:	(818) 274-1809
CITY:	LAKE BALBOA	STATE: CA	ZIP CODE:	91406
CAPACITY:	4	CENSUS: 4	DATE:	06/05/2026
		UNANNOUNCED	TIME BEGAN:	09:44 AM
MET WITH:	Toluwalope Adefemiwa		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff mishandled resident’s P&I.
Staff are not allowing resident access to telephone.
Staff did not treat resident with dignity and respect.
Staff consumed alcohol during work hours, impairing their ability to provide adequate care and supervision, which presents a risk to residents in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sandra Urena conducted an unannounced subsequent visit to deliver findings for the allegations listed above. The LPA was greeted by staff, and staff contacted the deignated facility staff Toluwalope Adefemiwa on the phone. The LPA met with the Administrator and explained the reason for the visit.

On 02/19/2026, Licensing Program Analyst (LPA) Sandra Urena conducted an initial unannounced visit to investigate the allegations listed above. The LPA met with Toluwalope Adefemiwa and explained the reason for the visit. LPA Urena interviewed residents, staff and the administrator. The LPA requested records pertinent to the investigation.

Continueson LIC 9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Sandra Urena
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2026

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 29-AS-20260213100640

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: SUNSHINE RESIDENTIAL HOME BALBOA	FACILITY NUMBER: 195850090
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/05/2026

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/12/2026 Section Cited CCR 85078(a)(1)	1 2 3 4 5 6 7	85078 Responsibility for Providing Care and Supervision (a)...the following shall apply: (1)The licensee shall provide those services identified in the client's needs and services plan as necessary to meet the client's needs. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	The administrator agreed to submit a signed written statement of understanding and acknowledgement of section 85078. by due date to CCL LPA.
	8 9 10 11 12 13 14	Based on interview and record review, the licensee did not comply with the section cited above in that staff did not support R1’s needs as outlined in their care plans, which posed a potential health, safety and personal rights risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Sandra Urena
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2026

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20260213100640

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: SUNSHINE RESIDENTIAL HOME BALBOA	FACILITY NUMBER: 195850090
	VISIT DATE: 06/05/2026

NARRATIVE

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Staff mishandled resident’s P&I.
On the allegation that staff mishandled the resident’s P&I, it is alleged that staff will promise the resident (R1) things like hair gel and drinks, by using R1’s P&I, but then staff will tell R1 that R1 doesn’t have enough money. LPA Urena conducted record review of the P&I, and records review revealed that P&I documents to be in order. Interview with R1 indicated that they did receive P&I to make personal purchases. The Administrator’s interview revealed that all P&I provided to residents is documented and a record is kept.
Based on the information obtained through record review and interviews, the allegation that the residents’ P&I is being mishandled, is deemed Unsubstantiated at this time.

Staff are not allowing resident access to telephone.
On the allegation that staff are not allowing the resident (R1) to access the facility telephone, it is alleged that staff do not allow R1 to use the facility’s landline telephone in their room. During the tour of the home, the LPA verified that facility’s home telephone was in operation and through interviews with facility staff; staff stated that they were aware that residents have the right to always use the telephone in a confidential setting. Interview with facility residents, revealed that they have access and are allowed to use the facility’s telephone privately. Interview with the Administrator revealed that sometimes R1 wants to be on the phone for extended periods of time, limiting the use of the telephone to other residents. The R1 reported that staff disconnect the telephone when R1 takes it to their room. Information obtained through the NLACRC Community Services Specialist (CSS), indicated that they had interviewed R1 about the allegation, and R1 confirmed to the CSS that R1 had access to the home telephone in a confidential setting.

Although the allegation may have happened or is valid, based on the interviews, and observation; there is not sufficient evidence to prove the alleged violation(s) did or did not occur. Therefore, the allegation is deemed Unsubstantiated at this time.

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Sandra Urena
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/13/2026 and conducted by Evaluator Sandra Urena

COMPLAINT CONTROL NUMBER: 29-AS-20260213100640

FACILITY NAME:	SUNSHINE RESIDENTIAL HOME BALBOA		FACILITY NUMBER:	195850090
ADMINISTRATOR:	JOSE, OYINLOYE AUSTINE		FACILITY TYPE:	735
ADDRESS:	7431 JELLICO AVENUE		TELEPHONE:	(818) 274-1809
CITY:	LAKE BALBOA	STATE:CA	ZIP CODE:	91406
CAPACITY:	4	CENSUS: 4	DATE:	06/05/2026
		UNANNOUNCED	TIME BEGAN:	09:44 AM
MET WITH:	Toluwalope Adefemiwa		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Licensee does not adhere to staff-client ratio requirements.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Sandra Urena conducted a subsequent visit to deliver findings for the allegation listed above. The LPA met with the facility desiganted staff and explained the reason for the visit. On 02/19/2026, Licensing Program Analyst (LPA) Sandra Urena conducted an initial unannounced visit to investigate the allegations listed above. LPA Urena interviewed residents, staff and the administrator. Licensee does not adhere to staff-client ratio requirements.On the allegation that the staff does not provide appropriate supervision for the residents in care, it is alleged that R1 is not being accompanied by their one-to-one to personal events during the weekend. The LPA interviewed the Administrator, and the interview revealed that the resident chose to go on their own, accompanied by acquaintances to personal events. However, the residents’ individual plan (IP)states that the residents must be accompanied by the facility one-to one-staff. Record review of the resident’s IP indicates that the residents has a one-to-one for off facility events. Based on the information obtained through interviews and record review, the licensee is not adhering to staff-client ratios based on the client’s individual plan. Therefore, the allegation is deemed Substantiated at this time. Ciataions were issued. Exit interview was conducted, report and appeal rights were issued.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Sandra Urena
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2026

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 5

Control Number 29-AS-20260213100640

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: SUNSHINE RESIDENTIAL HOME BALBOA	FACILITY NUMBER: 195850090
	VISIT DATE: 06/05/2026

NARRATIVE

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Staff consumed alcohol during work hours, impairing their ability to provide adequate care and supervision, which presents a risk to residents in care.

On the allegation that staff consumed alcohol during work hours, impairing their ability to provide adequate care and supervision, which presents a risk to residents in care, it is alleged that staff consumed alcohol during facility celebrations. The LPA interviewed the resident (R1) about the alleged alcohol consumption and the R1 reported that they had seen bottles that said “wine” at a social gathering that took place at around a couple of years ago. The resident was not exactly sure of the date and the social gathering. Interview with the Administrator revealed that facility staff do not consume alcohol while residents are present. Staff denied consuming alcohol during social gathering with residents present.

Although the allegation may have happened or is valid, based on the interviews; there is not sufficient evidence to prove the alleged violation(s) did or did not occur. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff did not treat resident with dignity and respect.

On the allegation that the residents do not get treated with dignity and respect, it is alleged that the staff make the resident go to their room whenever they find R1 to be quite annoying, and facility staff yells to the resident when the resident asks for their medication, making the resident feel neglected and ignored. LPA Urena conducted residents’ interviews and staff interviews. The staff denied yelling or ignoring the residents. Two out of two residents reported that staff do not yell. R1’s interview revealed that they had no issues with any direct care staff mistreating them; furthermore, R1 denied being requested to stay in their bedroom against their wishes.

Based on the information obtained through interviews, the allegation that the resident was not treated with dignity and respect, is deemed Unsubstantiated at this time.

Exit interview was conducted. A copy of the report was issued.

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Sandra Urena
LICENSING EVALUATOR SIGNATURE:	DATE: 06/05/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/05/2026

LIC9099 (FAS) - (06/04)

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