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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197607799
Report Date: 02/03/2022
Date Signed: 02/03/2022 02:34:26 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. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/22/2021 and conducted by Evaluator Zabel Chochian
COMPLAINT CONTROL NUMBER: 29-AS-20210222111501
FACILITY NAME:SAILS SIMIFACILITY NUMBER:
197607799
ADMINISTRATOR:AYOBAMI TEMILOLUWAFACILITY TYPE:
735
ADDRESS:3311 TAPO CANYON RDTELEPHONE:
(818) 224-7222
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93063
CAPACITY:4CENSUS: 3DATE:
02/03/2022
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Marchelino RoosTIME COMPLETED:
10:45 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff spoke inappropriately to resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Zabel Chochian conducted an unannounced subsequent complaint visit to deliver final investigation finding regarding above allegations. During today’s visit LPA Chochian met with staff and explained reason for visit. Staff contacted new Administrator Marchelino Roos who arrived shortly after. Reason for visit was explained to Mr. Roos. Following is a summary of the investigation finding:
On 02/22/2021, the Department received a complaint alleging that a “Staff spoke inappropriately to resident. It was alleged that facility staff (name unknown) spoke inappropriately to resident 1 (R1) calling resident a "retard" and said "you are acting like a stupid little kid". On 02/24/2021, LPA conducted interviews with residents including R1. R1 appeared very upset during the interview. R1 reported being upset about personal matters; R1 expressed that this is the reason R1 runs away from the facility. Interview with R1 did not confirm or deny that “staff speak inappropriately to residents”. Other residents interviewed denied staff speaking inappropriately to them. Staff interviewed denied allegation. Based on the information gathered through interviews, there is not sufficient evidence to support the allegation. Therefore, the allegations are deemed Unsubstantiated at this time. Exit interview, copy of report provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2022
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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