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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608828
Report Date: 12/04/2025
Date Signed: 12/04/2025 02:32:40 PM

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
12/03/2025 and conducted by Evaluator Angelica Segovia
COMPLAINT CONTROL NUMBER: 31-AS-20251203134604
FACILITY NAME:SVS LANCASTER ADULT DAY PROGRAMFACILITY NUMBER:
197608828
ADMINISTRATOR:LETICIA CAMPBELLFACILITY TYPE:
775
ADDRESS:846 W. LANCASTER BLVD.TELEPHONE:
(661) 729-5954
CITY:LANCASTERSTATE: CAZIP CODE:
93534
CAPACITY:75CENSUS: 24DATE:
12/04/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Leticia Campbell- Regional DirectorTIME COMPLETED:
02:50 PM
ALLEGATION(S):
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Due to lack of supervision, client was touched inappropriately by another client.
INVESTIGATION FINDINGS:
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On 12/04/2025 at approximately 10:00 AM, Licensing Program Analyst (LPA) Angelica Segovia conducted an unannounced initial complaint visit to the facility. LPA was greeted by the Regional Director, Leticia Campbell and stated the reason for their visit.


To investigate the allegation(s), at approximately 10:20 AM, LPA conducted a physical plant tour. By 11:00 AM, LPA requested relevant documentation. From 11:00 AM to 2:30 PM, LPA conducted record review and attempted interviews with five (5) clients (C1-C5) and six (6) staff members (S1-S6).


(continue to LIC 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Angelica Segovia
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025
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-20251203134604
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: SVS LANCASTER ADULT DAY PROGRAM
FACILITY NUMBER: 197608828
VISIT DATE: 12/04/2025
NARRATIVE
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Regarding the allegation: Due to lack of supervision, client was touched inappropriately by another client. It was alleged that staff failed to supervise clients, resulting in one (1) client (C2) touching another client (C1) inappropriately. To investigate the allegation, LPA attempted interviews with five (5) clients and six (6) staff members. LPA’s interview with C1 revealed that C2 had grasped their inner thigh near their private area but denied C2 had touched their private area. When questioned if they spoke to staff regarding the incident, C1 confirmed. LPA’s interview with C2 revealed that they did not want to speak about the incident in question but did mention staff were present, LPA then terminated the interview. When questioned if staff were present during their outing all five (5) clients confirmed that staff were present and did not leave them alone. LPA’s interview with two (2) clients revealed that they witnessed C2 touch C1 near their private area, however LPA’s interview with C5 revealed that they were in the immediate enclosed area of said incident and did not witness C2 touch C1.

LPA’s interview with five staff (5) staff members revealed that the incident in question was a misunderstanding between both clients (C1-C2). When the incident was brought to their attention, the facility conducted their own investigation where it was concluded that C2 had not touched C1 in their private area and they have never witnessed C2 touch any other clients inappropriately. LPA attempted to interview S5 but they were not present nor could be contacted. However, during LPA’s record review of the facility’s Service Notes, both S5 and S6 (whom were present during the time of the incident) had documented the incident where inappropriate behavior between both clients may have occurred but was not witnessed.

LPA’s record review of the facility’s Unusual Incident Reports (SIRs) showcased that C2 has had a few behavioral incidents but nothing pertaining to inappropriate behavior has been reported. During LPA’s physical plant tour, LPA observed multiple staff members with their group of clients. LPA did not observe any clients to be left alone and without any supervision.

Based on interviews, record review and observations there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

No immediate health and safety issues observed during the day of the visit. Exit interview conducted and a copy of this report was provided to the Administrator.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Angelica Segovia
LICENSING EVALUATOR SIGNATURE:

DATE: 12/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025
LIC9099 (FAS) - (06/04)
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