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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609554
Report Date: 06/17/2025
Date Signed: 06/17/2025 02:25:27 PM

Substantiated


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
06/11/2025 and conducted by Evaluator Michael Cava
COMPLAINT CONTROL NUMBER: 31-AS-20250611104642
FACILITY NAME:SUNSHINE RESIDENTIAL HOME WOODLEYFACILITY NUMBER:
197609554
ADMINISTRATOR:JOSE, OYINLOYE AUSTINEFACILITY TYPE:
735
ADDRESS:10534 WOODLEY AVENUETELEPHONE:
(818) 274-1809
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:4CENSUS: 4DATE:
06/17/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Toluwalope JoseTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff are not properly trained
Staff do not ensure personnel files are updated
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to investigate the above allegations. LPA met with the administrator, Toluwalope Jose, and advised her of the complaint.

Staff are not properly trained/Staff do not ensure personnel files are updated:
Regarding the above allegations, on or around 04/07/25, Resident 1 (R1) exhibited an aggressive behavior that required intervention and the use of Crisis Prevention Institute (CPI) technique. It was reported that the licensee failed to ensure compliance with staff training and qualifications standards regarding CPI training. In addition, the following items were found non-compliant based on an agency review:

1. Staff did not have valid certificates.
2. No indication that the trainings were provided by an individual holding a valid instructor
certificate from a program.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2025
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 5
Control Number 31-AS-20250611104642
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: SUNSHINE RESIDENTIAL HOME WOODLEY
FACILITY NUMBER: 197609554
VISIT DATE: 06/17/2025
NARRATIVE
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3. No indication that staff had hands-on competency test administered by a certified trainer.
4. Licensee did not maintain a copy of the trainer's certificate thus not available for review.
5. Licensee did not maintain a written record of the staff training.
6. Licensee did not have written verification from the instructor that the staff member has
successfully completed the required training and passed the competency test(s).
7. Unable to determine if staff utilized the least to most restrictive type(s) of manual
restraints.

In addition to the agency review, the facility administrator acknowledged that staff did not utilize “proper CPI techniques” when Resident 1 (R1) was hitting the floor.

Based on the agency review, there was sufficient evidence to confirm the allegations of Staff are not properly trained/Staff do not ensure personnel files are updated. Therefore, the allegations are Substantiated. Citations issued on the 9099D. Administrator advised, and a copy of this report issued.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 31-AS-20250611104642
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: SUNSHINE RESIDENTIAL HOME WOODLEY
FACILITY NUMBER: 197609554
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/17/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/10/2025
Section Cited
CCR
85165(b)(1)
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Emergency Intervention Staff Training- Staff who use, participate in, approve or provide visual checks of manual restraints or seclusions, shall be trained in the manual restraint or seclusion technique utilized. This requirement was not met as evidenced by information the agency received that there
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Licensee was given a Corrective Action Plan (CAP) due July 10, 2025. As POC, copy of this plan is due to CCL on July 10, 2025.
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is no documentation that that Staff 1, 2 & 3 have valid CPI certificates. This is a potential health and safety risk to the clients in care.
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Type B
07/10/2025
Section Cited
CCR
85165(c)
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Emergency Intervention Staff Training- The training shall be provided by an individual holding a valid instructor certificate. This requirement was not met as evidenced by information the agency received that the instructor, utilized by licensee to provide CPI training, does not have a valid instructor
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Licensee was given a Corrective Action Plan (CAP) due July 10, 2025. As POC, copy of this plan is due to CCL on July 10, 2025.
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certificate. This is a potential health and safety risk to the clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
06/11/2025 and conducted by Evaluator Michael Cava
COMPLAINT CONTROL NUMBER: 31-AS-20250611104642

FACILITY NAME:SUNSHINE RESIDENTIAL HOME WOODLEYFACILITY NUMBER:
197609554
ADMINISTRATOR:JOSE, OYINLOYE AUSTINEFACILITY TYPE:
735
ADDRESS:10534 WOODLEY AVENUETELEPHONE:
(818) 274-1809
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:4CENSUS: 4DATE:
06/17/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Toluwalope JoseTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
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Staff do not ensure incidents are properly documented
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to investigate the above allegation. LPA met with the administrator, Toluwalope Jose, and advised her of the complaint. Today's investigation consisted of interviews, record review, and a physical plant inspection.

In regards to the allegation, it was reported that on or around 04/07/25, Resident 1 (R1) exhibited an aggressive behavior that required intervention and the use of Crisis Prevention Institute (CPI) technique. Incident was reported to the proper agencies, including Community Care Licensing (CCL) timely, but according to a report that was received, pursuant to title 17, the Incident Report (IR) “lacked descriptions of types of restraints used, duration of restraints, description of the precipitating factors, including description of what non-physical interventions were utilized prior to the use of the manual restraint; description of any injuries at the completion of the manual restraint; was medical assessment and or treatment sought, and if not why”.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 31-AS-20250611104642
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: SUNSHINE RESIDENTIAL HOME WOODLEY
FACILITY NUMBER: 197609554
VISIT DATE: 06/17/2025
NARRATIVE
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Review of the facility file confirm that an incident, of this description was submitted and reviewed by CCL on 04/11/25, to satisfy the facility’s reporting requirements. A further review, of the facility's Program Description, that was submitted to CCL, and is on file, does not specify that the licensee will report what is required to comply with title 17 (stated above) to CCL. According to the facility’s Incident Reporting Procedure, “Any incident that threatens the welfare, safety or health of any client, such as physical or psychological abuse of a client by staff or other clients, a written report will be submitted within 7 days…” No other statements, indicated on the facility’s Program Description state that the IR submitted to CCL will include the information that is required of, pursuant to title 17.

Based on the information received, and a review of the facility file, although the licensee’s IR that was submitted to the proper agencies lacked information required of title 17, pursuant to title 22, the licensee met their requirements indicated on their Program Description in Incident Reporting Procedures. Therefore, the allegation of staff do not ensure incidents are properly documented is deemed Unsubstantiated at this time. Administrator advised and a copy of this report issued.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5