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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609482
Report Date: 09/04/2024
Date Signed: 09/04/2024 04:10:34 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.ASC, 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
08/30/2024 and conducted by Evaluator Nicholas Reed
COMPLAINT CONTROL NUMBER: 31-AS-20240830123848
FACILITY NAME:PARAMOUNT SPECIAL HOME CARE CORPORATIONFACILITY NUMBER:
197609482
ADMINISTRATOR:QUIJANO, LOIDAFACILITY TYPE:
735
ADDRESS:7044 FALLBROOK AVETELEPHONE:
(747) 226-1864
CITY:WEST HILLSSTATE: CAZIP CODE:
91307
CAPACITY:4CENSUS: 4DATE:
09/04/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Loida QuijanoTIME COMPLETED:
04:10 PM
ALLEGATION(S):
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Facility staff used unusual form of punishment
INVESTIGATION FINDINGS:
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At approximately 9:00 a.m. on 09/04/24, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with Staff #1 (S1) and laer the administrator and disclosed the reason for the visit.

To investigate the allegation above, LPA toured the facility inside and out at 9:00 a.m. today, interviewed two (02) out of four (04) clients between 9:10 a.m. and 9:30 a.m., S1 at 9:40 a.m., and reviewed pertinent records at 10:00 a.m. including but not limited to a medical assessment, program plan, and identification and contact form. LPA conducted a collateral visit at 1:00 p.m. today and interviewed Client #2 (C2). LPA also telephonically interviewed C2’s service coordinator at 1:30 p.m. and the administrator at 3:10 p.m. today.

Regarding the allegation “Facility staff used unusual form of punishment” it was alleged S1 used a garden hose to spray Client #1 (C1). Facility tour revealed the facility has no cameras, so there was no video footage of the alleged events to review. Interview with C1 at 9:10 a.m. today revealed no pertinent information.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2024
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 2
Control Number 31-AS-20240830123848
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: PARAMOUNT SPECIAL HOME CARE CORPORATION
FACILITY NUMBER: 197609482
VISIT DATE: 09/04/2024
NARRATIVE
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Interview with Client #3 (C3) at 9:20 a.m. today revealed S1 has never used a hose to spray any clients, and S1 has never abused any clients. Interview with C2 revealed they witnessed C1 trying to break the garage door, so S1 sprayed C1 with the garden hose for about four (04) minutes. Interview with S1 revealed they have never abused any clients nor used the hose to spray C1. S1 recalled that about two (02) weeks ago, C1 was banging at the rear sliding door which S1 identified as C1's way of wanting to go outside. S1 further stated that C2 has made up some stories in the past few weeks. Interview with C2’s service coordinator confirmed that C2 has made up some stories in the past few weeks. Interview with the administrator corroborated S1's and C2's service coordinator's statements. Based on interviews and observations, S1 did not use the hose to spray any clients in the home. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

No immediate health and safety risks were observed during today’s visit.

Exit interview conducted. Copy of report provided.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 09/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2