197609009-9-11-2024-31-AS-EMIR-DAHNAQ-20241029101754

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609009
Report Date: 09/11/2024
Date Signed: 09/11/2024 02:23:14 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
10/03/2023 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20231003081416

FACILITY NAME:	ELWYN CALIFORNIA - YARMOUTH		FACILITY NUMBER:	197609009
ADMINISTRATOR:	TAYO LABEODAN		FACILITY TYPE:	735
ADDRESS:	10512 YARMOUTH AVE		TELEPHONE:	(818) 488-1753
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY:	4	CENSUS: 3	DATE:	09/11/2024
		UNANNOUNCED	TIME BEGAN:	11:58 AM
MET WITH:	Gerlie Miguel		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff inappropriately touches resident in their private parts

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Michael Cava conducted a subsequent visit to the facility to close out the investigation regarding the above allegation. LPA met with staff/LVN, Gerlie Miguel, and advised her of the complaint. It was reported that Resident 1 (R1) was touched inappropriately by Staff 1 (S1) on at least three occasions. When R1 had asked S1 to stop, S1 ignores that request. Because of this, R1 does not feel safe being at the facility. No witnesses were identified. R1 advised their family, but family did not believe R1’s report. Investigation consisted of the following:

On 10/03/23 the complaint was referred to and accepted by Investigations Branch (IB) to conduct interviews. (IB) Investigator, Christine Ferris, was given the assignment.

On 10/04/23, LPA Panushkina and Cava made the initial visit to insure the health and safety of the residents in care. A physical plant inspection and record review was made.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2024

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-20231003081416

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: ELWYN CALIFORNIA - YARMOUTH	FACILITY NUMBER: 197609009
	VISIT DATE: 09/11/2024

NARRATIVE

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On 10/10/23, IB Ferris conducted her visit to the facility and interviewed the administrator at that time, Tayo Labeodan. IB Ferris interview with the administrator reveal that the facility is a level four group home. Administrator stated R1 moved into the home 07/20/23. Since moving in the home, R1 had a history of calling 911, making false accusation. IB Ferris then asked the administrator if S1 worked at the facility, and provided a description of S1. Administrator denied S1 working at the facility, or anyone fitting the alleged description given by IB. A review of the facility personnel via Licensing Information System (LIS) showed no one associated to the facility under S1’s name. IB Ferris also obtained copies of Incident Reports (IRs) pertaining to R1’s 911 calls for record.

On 10/16/24, IB Ferris made contact with R1’s Case Manager (CM) with North Los Angeles Regional Center (NLARC). According to CM, R1 is “a difficult one”, and is currently at a behavioral unit at the hospital. Furthermore, CM stated R1 has a history of making false allegations, and has made multiple sexual abuse allegations when they do not get what they want.

On 10/19/23, IB Ferris made a second visit to the facility to interview R1, who did not disclose sexual abuse. R1 did identify S1, who is confirmed not to have ever worked at the facility, and another staff, Staff 2 (S2), who just transferred, and has only worked at the facility for six months. There have been no complaints made against S1 in the past, and no witnesses identified to corroborate with R1’s allegation.

Based on the information obtained by IB Ferris, there was insufficient evidence to prove that Staff inappropriately touches R1 in their private parts. Therefore, the allegation is deemed Unsubstantiated at this time.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2024

LIC9099 (FAS) - (06/04)

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