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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197600256
Report Date: 04/03/2024
Date Signed: 04/03/2024 02:44:49 PM

Unsubstantiated


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
03/29/2024 and conducted by Evaluator Michael Cava
COMPLAINT CONTROL NUMBER: 31-AS-20240329125542
FACILITY NAME:EUNICE HOMEFACILITY NUMBER:
197600256
ADMINISTRATOR:AGBEDE, SONNYFACILITY TYPE:
735
ADDRESS:11611 BALBOA BLVD.TELEPHONE:
(818) 368-9242
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:6CENSUS: 6DATE:
04/03/2024
UNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Sonny Agbede, Malina Biluan, Cherish AbatiTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Due to neglect, resident receiving unexplained injures
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to the facility to investigate the above allegation. Its' being alleged that the residents in the home is observed to have unexplained bruises. The bruieses that were observed are scratches to a female resident's leg, scrapes and a black eye to another (male) resident's face. No witnesses identified to the allegation. LPA met with the house manager, Malina Biluan, and staff, Cherish Abati, and advised them of the complaint. Administrator, Sonny Agbede, joined the visit shortly after. Today's investigation consisted of Interviews with the administrator, two (2) of two staff, and attempted interviews with six (6) of six residents.

The facility is a level 4G. LPA was advised by staff that all of the residents in the home have a history of an aggressive behavior and at anytime, can engage in self injury, or cause an injury to others (staff or peers). The facility has up to three (3) staff on duty all during the day (LIC 500 obtained for review). A physical plant inspection was made, and LPA Cava was shown wall and furniture damages caused by the residents.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024
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 2
Control Number 31-AS-20240329125542
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: EUNICE HOME
FACILITY NUMBER: 197600256
VISIT DATE: 04/03/2024
NARRATIVE
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In regards to the allegation of Resident 1 (R1) receiving unexplained injuries, interviews with the administrator and two (2) of two staff reveal that R1 can at times, engage in self injurious behaviors. Staff also indicated, most recently, that Resident 2 (R2), did engage in a behavior that caused an injury to R1, before staff can intervene or redirect. There is also history and incident reports documented of R1 sustaining injuries to self due to behavior episode. In regards to the female staff, who sustained scratches to their leg, the administrator and staff were not aware of this. Nothing of this incident was brought to their attention, or observed by either the residents or staff.

Attempts to interview with six (6) of six could not confirm the allegation. All six residents are non-verbal, have limited communication and could not answer the LPAs questions. LPA unable to determine any witnesses or confirm the allegations.

Based on the information obtained, it could not be proven that the unexplained injuries to the residents were due to neglect. Therefore, the allegation is deemed Unsubstantiated at this time.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2