197609335-10-1-2024-31-AS-NGID-DAANZG-20241022105415

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609335
Report Date: 10/01/2024
Date Signed: 10/01/2024 08:13:18 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
07/17/2023 and conducted by Evaluator Angela Panushkina

COMPLAINT CONTROL NUMBER: 31-AS-20230717125237

FACILITY NAME:	PEOPLE'S CARE MCENNERY CANYON		FACILITY NUMBER:	197609335
ADMINISTRATOR:	NAZARETH DUENAS		FACILITY TYPE:	735
ADDRESS:	34310 MCENNERY CANYON RD		TELEPHONE:	(661) 269-2679
CITY:	ACTON	STATE: CA	ZIP CODE:	93510
CAPACITY:	4	CENSUS: 4	DATE:	10/01/2024
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Sarah Long, Administrator		TIME COMPLETED:	03:50 PM

ALLEGATION(S):

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Staff used inappropriate form of punishment with client
Staff hit client
Staff spoke inappropriately to client

INVESTIGATION FINDINGS:

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At 1:30pm, Licensing Program Analysts (LPAs), Angela Panushkina and Huma Rahimi, conducted a subsequent visit to deliver final report. LPAs met with the Administrator and explained the reason for the visit.

During the initial visit, conducted on 07/26/23 by LPA Ruiz, copies of pertinent information which include, but not limited to Physician’s report, Admission Agreement, Appraisal Needs and Services Plan, Staff Training, relevant to the investigation were requested. LPA Ruiz also conducted interviews with the staff and clients.

On 07/27/24, LPA Panushkina conducted additional interviews with the Administrator, and a Service Coordinator from North Los Angeles Regional Center (NLARC). Moreover, during today’s visit LPAs conducted an interview with one (1) staff, two (2) out of four (4) clients and collected additional documents related to this investigation.
Continue on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024

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-20230717125237

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: PEOPLE'S CARE MCENNERY CANYON	FACILITY NUMBER: 197609335
	VISIT DATE: 10/01/2024

NARRATIVE

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Allegation: Staff used inappropriate form of punishment with client

It was alleged that on 07/16/23, C1 could not go on a facility outing because of the way C1 treated staff earlier that day. To investigate this allegation, on 07/26/23 LPA Ruiz conducted an initial visit to this facility and interviewed S2, who confirmed that he/she along with other three (3) staff members witnessed how S1 inappropriately punished C1. However, when LPA Ruiz conducted an interview with the Designee, the District Manager and two (2) staff members, all parties interviewed denied the above allegation. Moreover, during today’s visit, LPAs conducted an additional interview with the Designee (current Administrator) and were informed that during C1’s aggressive behavior/episode, the staff is trained to deescalate the situation and if no changes observed then based on C1’s Residential Behavior Assessment and Support Plan, C1 cannot go on an outing that day due to a potential danger to the public. Lastly, interview with two (2) clients expressed no concerns regarding the above allegation. Based on interviews and C1’s facility file reviews this allegation is deemed Unsubstantiated at this time.

Allegation: Staff hit resident.

It was alleged that on 07/16/23, S1 slapped C1 on the back which made C1’s body move forward. To investigate this allegation, on 07/26/23 LPA Ruiz conducted an initial visit to this facility and interviewed S2, who confirmed that he/she along with other three (3) staff members witnessed how S1 hit C1. However, when LPA Ruiz conducted an interview with the Designee, the District Manager and two (2) staff members, all parties interviewed denied the above allegation. Moreover, during today's visit, LPAs conducted an interview with the Administrator and one (1) staff that was present during the “incident”. Both parties interviewed also denied the above allegation and informed LPAs that S1 was always very professional towards his/her job and would never hit clients. Additionally, interview with C1 revealed that S1 was really good to him/her and could not confirm that the above allegation occurred. Lastly, review of an incident report submitted to the Community Care Licensing (CCL) on 09/19/23 revealed that “upon getting hit from C1, S1 blocked C1’s hand from hitting S1 again and one hour later, C1 apologized to S1 for his/her inappropriate behavior.” Therefore, based on interviews and review of “Special Incident Report” this allegation is deemed Unsubstantiated at this time.
Continue on LIC9000-C

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20230717125237

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: PEOPLE'S CARE MCENNERY CANYON	FACILITY NUMBER: 197609335
	VISIT DATE: 10/01/2024

NARRATIVE

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Allegation: Staff spoke inappropriately to client

It was alleged that on 07/16/23, C1 was using foul language towards S1 and S1 inappropriately replied back to C1. To investigate this allegation, on 07/26/23 LPA Ruiz conducted an initial visit to this facility and interviewed S2, who confirmed that he/she along with other three (3) staff members witnessed how S1 inappropriately spoke with C1. However, when LPA Ruiz conducted an interview with the Designee, the District Manager and two (2) staff members, all parties interviewed denied the above allegation. Moreover, during today’s visit, LPAs conducted an interview with the Administrator and one (1) staff member and both parties informed LPAs that S1 had a very professional way of de-escalating such behaviors. Lastly, interview with two (2) clients expressed no concerns regarding this allegation. Therefore, based on interviews this allegation is deemed Unsubstantiated at this time.

Exit interview conducted and copy of this report signed and delivered

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Angela Panushkina
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024

LIC9099 (FAS) - (06/04)

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