197607040-9-9-2025-31-AS-NGID-DMVMQ2-20251028094802

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197607040
Report Date: 09/09/2025
Date Signed: 09/09/2025 10:04:11 AM

Unsubstantiated

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
06/05/2025 and conducted by Evaluator Lorena Casillas

COMPLAINT CONTROL NUMBER: 31-AS-20250605102347

FACILITY NAME:	POWELL HOUSE IV		FACILITY NUMBER:	197607040
ADMINISTRATOR:	LINDA HUGHES		FACILITY TYPE:	735
ADDRESS:	43669 E. 6TH STREET		TELEPHONE:	(661) 729-2454
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93535
CAPACITY:	4	CENSUS: 3	DATE:	09/09/2025
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Thomasina Woods		TIME COMPLETED:	10:15 AM

ALLEGATION(S):

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Staff yells at resident in care.
Staff are not properly trained.

INVESTIGATION FINDINGS:

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On 09/09/25 at 09:15 am Licensing Program Analyst (LPA) Lorena Casillas conducted an unannounced subsequent complaint visit to investigate the above stated allegations. LPA was greeted by staff member who called Administrator and LPA explained the reason for the visit. Administrator would not be able to meet with LPA and designated staff member Thomasina Woods to sign report.

On 06/05/25 the Woodland Hills South Adult and Senior Care Regional Office received a complaint regarding the allegations: Staff yells at resident in care and Staff are not properly trained.

On 06/13/2025 an initial visit was conducted by LPA Casillas. On that day LPA conducted a tour of the facility, interviewed with Administrator, staff and clients, 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: 09/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2025

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 31-AS-20250605102347

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: POWELL HOUSE IV	FACILITY NUMBER: 197607040
	VISIT DATE: 09/09/2025

NARRATIVE

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Allegation: Staff yells at residents in care.

It is alleged that staff yells at residents in care. Regarding this allegation it is reported that staff yelled at Client #1 (C1) however no details were given of date, time or what was allegedly yelled. LPA interviewed Administrator and it was revealed that it is in fact C1 that yells racial slurs and curses at staff. Administrator stated that C1 has had frequent behaviors in which C1 will lose their temper and begin to verbally attack staff, sometimes verbally attacking other clients. C1 is continuously redirected by staff to include taking C1 for a walk, however C1 has been having ongoing increasing behaviors. Administrator states that they are actively working with North Los Angeles Regional Center (NLARC) to help C1. However, that has also proven challenging because C1’s parent has been involved and is also verbally aggressive towards Administrator, facility staff and NLARC staff. Interview with Staff #1 (S1) corroborated what Administrator stated. S1 revealed that C1 has had escalated behaviors that frequently occur after C1 has gotten off the phone with their parent. LPA attempted to interview C1, however C1 refused to speak to LPA and would not share any information. LPA reviewed C1’s Individual Program Plan (IPP) and it was discovered that C1 engages in the behaviors that the Administrator and staff have stated and has had a long history of said behaviors. Based on interviews, observations and record reviews, this allegation is deemed unsubstantiated at this time.

Allegation: Staff are not properly trained.

It is alleged that staff are not properly trained. Regarding this allegation it is reported that staff at the facility lack proper training. LPA interviewed Administrator and it was revealed that all staff have proper documentation of training. Additionally, Administrator stated that all staff have monthly training sessions that are mandatory therefore stating that all staff are more than adequately trained. LPA conducted a file review of staff records and discovered that seven (7) out of seven (7) staff members all have initial training, direct support staff training, First Aid/CPR training and ongoing monthly training. Therefore, based on interview, observation and record review this allegation is deemed unsubstantiated.

No deficiencies noted, no citations issued. Exit interview conducted and copy of report given to designee.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2025

LIC9099 (FAS) - (06/04)

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