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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608967
Report Date: 02/06/2023
Date Signed: 02/06/2023 03:16:30 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., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/10/2021 and conducted by Evaluator Tuesday Cabiness
COMPLAINT CONTROL NUMBER: 31-AS-20210310140530
FACILITY NAME:SHANKS BOARD & CAREFACILITY NUMBER:
197608967
ADMINISTRATOR:AUSTIN SHANKS SR.FACILITY TYPE:
735
ADDRESS:13055 WEIDNER STREETTELEPHONE:
(818) 896-9304
CITY:PACOIMASTATE: CAZIP CODE:
91331
CAPACITY:6CENSUS: 4DATE:
02/06/2023
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Rita BellTIME COMPLETED:
03:20 PM
ALLEGATION(S):
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1. Residents are using drugs in the facility
2. Resident received injures while in care
3. Resident not receiving stimulus money
4. Lack of supervision resulting in resident being out in the community unsupervised
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tuesday Cabiness met with caregiver Rita Bell, who contacted Administrator Austin Shanks, who both were informed the reason of the visit. LPA delivered the final findings of the allegations mentioned above:

Allegation # 1: Residents are using drugs in the facility. Concerns were expressed that the facility is allowing residents to use drugs. On March 19, 2021, November 10, 2022, and during today’s visit, from various times, ranging from 10am to 430pm, LPA conducted interviews and obtained documents pertaining to the complaint. From the information obtained, it was revealed to LPA, that residents do not use drugs at the facility; but staff are aware that majority of the residents have been living at the facility for years and have some type of drug or alcohol problems. Residents are not allowed to drink at the facility, but they do outside of the facility. During today’s visit, LPA interviewed residents, and they denied using drugs at the facility. Therefore, based on interviews, LPA does not sufficient evidence to prove the allegation, and it’s UNSUBSTANTIATED at this time.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2023
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 2
Control Number 31-AS-20210310140530
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., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: SHANKS BOARD & CARE
FACILITY NUMBER: 197608967
VISIT DATE: 02/06/2023
NARRATIVE
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Allegation # 2: Resident received injures while in care. Concerns were expressed that the resident # 1 (R1) received injuries while in care at the facility. On March 19, 2021, November 10, 2022, and during today’s visit, from various times, ranging from 10am to 430pm, LPA conducted interviews and obtained documents pertaining to the complaint. It was revealed to LPA, that resident #1 (R1) was no longer a resident when R1 was physically assaulted outside in the community. R1 walked to the facility to request for assistance and staff took R1 to urgent care for R1’s injuries. During today's interviews, several of the residents did not remember R1 or was not living at the facility during the time of the alleged injury. Therefore, LPA determined that R1 did not receive injuries while at the facility, and the allegation is UNSUBSTANTIATED at this time.

Allegation # 3: Resident not receiving stimulus money. On March 19, 2021, November 10, 2022, and during today’s visit, from various times, ranging from 10am to 430pm, LPA conducted interviews and obtained documents pertaining to the complaint. The Administrator reported to LPA, that all residents received stimulus money, except for R1, due to back payments of child support. Administrator also reported to LPA, that due to R1’s drug use, R1’s mother handled R1’s finances, and all money received and distributed was by R1’s mother. LPA interviewed resident’s and they confirmed, the Administrator distributed their stimulus funds, and others received it through mail. Also, because R1 is no longer a resident at the facility, LPA was unable to interview R1. Therefore, based on documentation received and interviews, LPA has insufficient evidence to prove the allegation, and it UNSUBSTANTIATED at this time.

Allegation # 4: Lack of supervision resulting in resident being out in the community unsupervised. On March 19, 2021, November 10, 2022, and during today’s visit, from various times, ranging from 10am to 430pm, LPA conducted interviews and obtained documents pertaining to the complaint. It was revealed to LPA, that resident #1 (R1) was no longer a resident when R1 was physically assaulted outside in the community. R1 walked to the facility to request for assistance and staff took R1 to urgent care for R1’s injuries. During today''s interviews, several residents did not remember R1, and LPA was unable to interview R1, due to R1 no longer living at the facility. Therefore, based on interviews, the allegation is deemed UNSUBSTANTIATED at this time.
SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 02/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/06/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2