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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609621
Report Date: 12/08/2022
Date Signed: 12/08/2022 12:38:43 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
04/26/2022 and conducted by Evaluator Tuesday Cabiness
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20220426085021
FACILITY NAME:GOLDEN ASSISTED LIVINGFACILITY NUMBER:
197609621
ADMINISTRATOR:LOPEZ, MONIQUEFACILITY TYPE:
740
ADDRESS:14060 ASTORIA STTELEPHONE:
(818) 367-1947
CITY:SYLMARSTATE: CAZIP CODE:
91342
CAPACITY:128CENSUS: 115DATE:
12/08/2022
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Monique LopezTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Resident was raped by another resident while in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tuesday Cabiness met with Administrator Monique Lopez and informed her the purpose of the visit. On April 26, 2022, the Woodland Hills Regional South Adult and Senior Care Office received a complaint for the allegation mentioned above. On April 26, 2022, the complaint was referred to the Community Care Licensing Division’s (CCLD’s) Investigations Branch (IB), and assigned to Investigator Brian Slatic, who determined the following:

It was alleged that client #1 (C1) raped client #2 (C2) while in care at the facility. From 10am to 11am, on April 27, 2022, the initial visit was conducted by LPA Wendell Smith, who conducted interviews with the Administrator, who revealed C2 had a boyfriend at the facility and C2 would allow other male clients in the room. It was also reported that C2 did not report the alleged rape to staff and they were unaware of the allegation. Over the course of the investigation, Investigator Brian Slatic reported that C2 was raped twice but denied sexual intercourse. C2 also disclosed C1 tried to have sex with C2 twice but was able to fight C1 off. Previously, C2 told facility staff that C2 engaged in consensual oral sex with C1. C2 did not disclose to
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Tuesday CabinessTELEPHONE: (818) 299-4975
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2022
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-20220426085021
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: GOLDEN ASSISTED LIVING
FACILITY NUMBER: 197609621
VISIT DATE: 12/08/2022
NARRATIVE
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Investigator Brian Slatic that C2 engaged in oral sex with C1. C1 reported to Investigator that sex was consensual and denied raping C2. Although C2 reported to the Los Angeles Police Department (LAPD) that the sex was not consensual, the department found no evidence of a crime and attempted to interview C2 on several occasions, but was not successful, and will not be investigating. Therefore, Investigator Brain Slatic determined that based on inconsistent statements about non-consensual or consensual sex between C1 and C2, and through interviews, the allegation was deemed UNSUBSTANTIATED at this time.

Exit interview and copy of report provided.
SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Tuesday CabinessTELEPHONE: (818) 299-4975
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2