197607799-2-3-2022-29-AS-DPEA-CBNU8G-20220215142132

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197607799
Report Date: 02/03/2022
Date Signed: 02/03/2022 02:39:05 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
08/27/2020 and conducted by Evaluator Zabel Chochian

COMPLAINT CONTROL NUMBER: 29-AS-20200827110402

FACILITY NAME:	SAILS SIMI		FACILITY NUMBER:	197607799
ADMINISTRATOR:	AYOBAMI TEMILOLUWA		FACILITY TYPE:	735
ADDRESS:	3311 TAPO CANYON RD		TELEPHONE:	(818) 224-7222
CITY:	SIMI VALLEY	STATE: CA	ZIP CODE:	93063
CAPACITY:	4	CENSUS: 3	DATE:	02/03/2022
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Marchelino Roos		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Staff spoke inappropriately towards client while in care
Staff threatened client while in care

INVESTIGATION FINDINGS:

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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 08/27/2020, the Department received a complaint alleging that a “Staff spoke inappropriately towards client while in care and Staff threatened client while in care”. It was alleged that on the morning of 8/26/2020 Sails Administrator Ayobami entered client 1’s (C1) room without knocking and spoke in threatening manner.

On 09/04/2020, LPA Chochian conducted the initial complaint visit. Due to the situation surrounding the Corona Virus Disease 2019 (COVID-19), and to implement mitigation measures, the initial complaint investigation was conducted telephonically with Administrator Ayobami Temiloluwa between the hours from 1:55 p.m. to 2:15 p.m. Administrator denied allegations and stated that he has never spoke inappropriately or threatened any client.

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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Control Number 29-AS-20200827110402

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. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: SAILS SIMI	FACILITY NUMBER: 197607799
	VISIT DATE: 02/03/2022

NARRATIVE

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Administrator expressed that clients do speak inappropriately to staff however he has not witnessed any other staff speak inappropriately or threaten any client. Administrator explained that staff are trained and handle clients who get aggressive by being patient, communicate with client to calm them down and redirect. Regarding C1, administrator stated that client #1 does not like it when staff ask client to stay home and not go out (during the state mandate to stay at home order) and that's the reason client reacts aggressively with staff and makes racial comments towards administrator. Other facility staff interviewed on 09/04/202 also denied allegation and stated that they have never threatened or spoke inappropriately towards any client. Staff stated that they have never witnessed administrator threaten or speak inappropriately towards any client. Interviews conducted with clients in the home denied feeling threatened by any staff/administrator. Clients expressed that staff and administrator are nice and treat them well.

LPA Chochian and Tri-Counties Regional Center (TCRC) Quality Assurance Specialist Freddie Garcia conducted a telephonic interview with C1 on 09/15/2020 at approximately 11:15a.m. C1 expressed that administrator C1 do not get along and there is no privacy in common areas of the facility and therefore gets agitates. Records reviewed indicated that C1 has a history of aggression towards facility staff, fabricating stories and noncompliance issues with the administrator.

Based on the information gathered through interviews and records reviewed, there is not sufficient evidence to support the allegations. Therefore, the allegations are deemed Unsubstantiated at this time.
Exit interview, copy of report provided.

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

LIC9099 (FAS) - (06/04)

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