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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197606660
Report Date: 04/13/2022
Date Signed: 04/13/2022 02:50:04 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
04/05/2022 and conducted by Evaluator Michael Cava
COMPLAINT CONTROL NUMBER: 31-AS-20220405134200
FACILITY NAME:JOY HOME CENTERFACILITY NUMBER:
197606660
ADMINISTRATOR:ZINAIDA AKSELRUDFACILITY TYPE:
735
ADDRESS:8042 MCNULTY AVENUETELEPHONE:
(818) 571-2247
CITY:CANOGA PARKSTATE: CAZIP CODE:
91306
CAPACITY:4CENSUS: 4DATE:
04/13/2022
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:TIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff hit client
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to facility to investigate the above allegation. LPA met with two staff, Jamada Kiyemba and Diane Bagoro. They were advised of the investigation. It is being alleged that Client 1 (C1) was physically abused by facility weekend staff. Dyring the course of the investigation, LPA conducted interviews and record review. Prior to the investigation, LPA interviewed the reporting party, who identified a couple names that C1 mentioned. Date and time not specified.

Interview with facility staff reveal that C1 has a history of making false allegations similar to this if they don't get what they want. Staff also mentioned that C1 gets physcally and verbally abusive with staff and the other clients when they doesn't get what they want. Furthermore, staff also state there is nobody that works at this facility, that goes by the names that were identified by the reporting party. Interviews with clients also do not corroborate with the allegation.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2022
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-20220405134200
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: JOY HOME CENTER
FACILITY NUMBER: 197606660
VISIT DATE: 04/13/2022
NARRATIVE
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Review of C1's file also reveal that C1 has aggressive behaviors. Facility also maintains documentation indicating the aggressive behaviors that C1 has been exhibiting during their stay at facility.

Based on the information obtained, there wasn't enough evidence to corroborate the allegation of staff hitting client. Therefore, the allegation is deemed Unsubstantiated at this time. Staff advised and a copy of this report provided.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2