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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608245
Report Date: 04/10/2024
Date Signed: 05/03/2024 10:16:01 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 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
03/16/2023 and conducted by Evaluator Evelin Rios
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20230316090901
FACILITY NAME:LOUISE HOUSE 2FACILITY NUMBER:
197608245
ADMINISTRATOR:JULIANN BARBERFACILITY TYPE:
735
ADDRESS:6455 TUSCAN COURTTELEPHONE:
(661) 526-3983
CITY:PALMDALESTATE: CAZIP CODE:
93552
CAPACITY:6CENSUS: 6DATE:
04/10/2024
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Jeanette Gonzalez (Administrator Designee) TIME COMPLETED:
04:45 PM
ALLEGATION(S):
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Staff is verbally aggressive with the client while in care.
Staff demonstrates inappropriate forms of punishment towards the clients.
INVESTIGATION FINDINGS:
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This report is being amended to include the date 04/30/2024, when the original report was in fact signed and delivered. Licensing Program Analyst (LPA) Evelin Rios conducted an unannounced subsequent complaint visit to the facility to deliver findings on the above allegations at approximately 2:30 p.m. LPA was greeted by staff #3 (S3) and advised they spoke with Juliann Barber and she said another administrator from another facility will be arriving to sign today’s report. At approximately 2:35 p.m. LPA interviewed S3 and at approximately 2:50 p.m. LPA conducted a physical plant tour of the facility to ensure the health and safety of the clients in care. LPA did not observe any issues or concerns. LPA met with an Administrator designee Jeanette Gonzalez at 3:00 p.m. and LPA explained the reason for the visit.

Allegation#1: Staff is verbally aggressive with the client while in care. It was alleged that a staff member yells at client(s) in care. To investigate this allegation, LPA Rios conducted an initial unannounced complaint visit on 03/21/2023. On 03/21/2023 visit, LPA Rios interviewed the administrator, Juliann Barber, client#1 (C1), two(2) staff present, and requested documents relevant to the investigation. (Continued on LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 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
03/16/2023 and conducted by Evaluator Evelin Rios
COMPLAINT CONTROL NUMBER: 31-AS-20230316090901

FACILITY NAME:LOUISE HOUSE 2FACILITY NUMBER:
197608245
ADMINISTRATOR:JULIANN BARBERFACILITY TYPE:
735
ADDRESS:6455 TUSCAN COURTTELEPHONE:
(661) 526-3983
CITY:PALMDALESTATE: CAZIP CODE:
93552
CAPACITY:6CENSUS: 6DATE:
04/10/2024
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Jeanette Gonzalez (Administrator Designee)TIME COMPLETED:
04:45 PM
ALLEGATION(S):
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2
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9
Staff mishandles the clients while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Evelin Rios conducted an unannounced subsequent complaint visit to the facility to deliver a finding on the above allegation at approximately 2:50 p.m. LPA conducted a physical plant tour of the facility to ensure the health and safety of the clients in care. LPA did not observe any issues or concerns at approximately 3:00 p.m. LPA met with an administrator designee Jeanette Gonzalez and explained the reason for the visit.

LPA Rios conducted an initial unannounced complaint visit on 03/21/2023. On 03/21/2023 visit, LPA Rios interviewed the administrator, Juliann Barber, client#1 (C1), two (2) staff present, and requested documents relevant to the investigation. On 03/21/2023 LPA Rios also conducted interviews with two (2) other clients living at the facility. On 04/29/2024 LPAs, Evelin Rios and Raymond Comer interviewed three (3) more clients living at the facility.
(Continued to LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 31-AS-20230316090901
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: LOUISE HOUSE 2
FACILITY NUMBER: 197608245
VISIT DATE: 04/10/2024
NARRATIVE
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(Continued from LIC9099)
Allegation: Staff mishandles the clients while in care. It was alleged staff has placed hands on client(s) in an aggressive manor. Interviews with six (6) out of six (6) clients, denied the allegation. Interviews with clients reveal staff has never handled them physically in an aggressive manor and they have never witnessed staff physically handle other clients in an aggressive manor. Staff interview does not corroborate clients' interviews. LPA Rios was unable to find another witness to corroborate the allegation.

Based on interviews, there is not enough information to verify the allegation did or did not happen. Therefore, the allegation is UNSUBSTANTIATED at this time.

Exit interview conducted. A copy of the report issued.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 31-AS-20230316090901
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: LOUISE HOUSE 2
FACILITY NUMBER: 197608245
VISIT DATE: 04/10/2024
NARRATIVE
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(Continued from LIC9099)
On 03/21/2023 LPA Rios also conducted interviews with two (2) other clients living at the facility. On 04/29/2024 LPAs, Evelin Rios and Raymond Comer interviewed three (3) more clients not already interviewed, living at the facility. Interview with Juliann on 03/21/2023, denied staff are verbally aggressive with clients. Interviews with four (4) out six (6) clients named the same staff member as having yelled at them or witnessing staff member yell at another client in the facility. Staff member named by clients matches the name mentioned on the complaint. Interviews with three (3) clients indicate the staff named on complaint has not yelled recently. Interview with staff working at the facility corroborates clients’ interviews, witnessing the staff member named in complaint, yelling at client(s).

Based on interviews, there is enough information to verify the allegation. Therefore, the allegation is SUBSTANTIATED at this time.

Allegation#2: Staff demonstrates inappropriate forms of punishment towards the clients. It was alleged staff member punishes clients in care. Interviews with three (3) out of six (6) clients described actions conducted by staff member named on complaint towards them or witnessing the staff member taking actions on another client, that would be considered punitive in nature by a reasonable person. Actions described by clients’ interviews were described as such but not limited to, staff member withholding personal item or refusing client an item meant for consumption. Furthermore, staff interview also describes actions carried out by staff member named in complaint, that a reasonable person would consider punitive in nature. Interview with Juliann on 03/21/2023, denied the allegation, staff demonstrates inappropriate forms of punishment towards the clients.

Based on interviews, there is enough information to verify the allegation. Therefore, the allegation is SUBSTANTIATED at this time.


The following deficiencies were cited (refer to LIC 9099-D). Exit interview conducted. A copy of the report and appeal rights issued.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 31-AS-20230316090901
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: LOUISE HOUSE 2
FACILITY NUMBER: 197608245
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/10/2024
Section Cited
CCR
80072(a)(1)
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(a) …each client shall have personal rights which include, but are not limited to, the following:(1)To be accorded dignity in his/her personal relationships with staff and other persons.
This requirement is not met as evidenced by:

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Administrator will have vendorized or in-house training on Personal Rights of the clients and provide a sign-in sheet of all staff that attended along with training topic(s) covered. Submit to LPA by POC due date.
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Based on interviews, the licensee did not comply with the section cited above, four (4) out of six (6) clients coroborate being yelled at or witnessing staff member yell at clients in care, which posed a potential health, safety or personal rights risk to persons in care.
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Type B
05/10/2024
Section Cited
CCR
80072(a)(3)
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(a) …each client shall have personal rights which include, but are not limited to, the following:(3) To be free from corporal or unusual punishment,..., punitive nature, including but not limited to: interference with the daily living functions...This requirement is not met as evidenced by:
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The Administrator will review regulation and submit a written letter certifying that, moving forward, they will ensure to follow and adhere to CCR Title 22 Personal Rights of clients. The written letter must be sent to the LPA by the POC due date.
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Based on interviews, the licensee did not comply with the section cited above, three (3) out of six (6) clients corroborate staff member in care dealt inappropriate forms of punishment towards the clients, which posed a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5