197609647-7-10-2026-31-AS-TAGD-DW2VCY-20260716161954

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609647
Report Date: 07/10/2026
Date Signed: 07/10/2026 05:03:19 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.RO, 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
04/20/2026 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20260420170522

FACILITY NAME:	WHITE'S ADULT HOME LLC		FACILITY NUMBER:	197609647
ADMINISTRATOR:	WHITE, EDMOND		FACILITY TYPE:	735
ADDRESS:	4054 TOURNAMENT DR		TELEPHONE:	(661) 526-3088
CITY:	PALMDALE	STATE: CA	ZIP CODE:	93551
CAPACITY:	4	CENSUS: 4	DATE:	07/10/2026
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Lidice Garcia		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Resident sustained bruises and scratched due to staff neglect or physical abuse.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced subsequent complaint visit to investigate the above-stated allegation. LPA met with Direct Support Professional, Lidice Garcia, and explained the purpose of the visit. LPA spoke with the administrator, Edmond White, and he designated Garcia to sign and accept this report.

---Resident sustained bruises and scratched due to staff neglect or physical abuse.

It was alleged that Staff #1 (S1) was being mean to Client #1 (C1), grabbing C1, leaving bruises on their arm and scratching thier chest. On April 22, 2026 at around 10:00a.m., LPA requested records and conducted a physical plant tour. LPA also spoke with other parties as the alleged victim’s name was not provided. During the investigation today, LPA requested copies of pertinent information relevant to the investigation at around 1:30p.m. LPA collected copies of the client roster, and LIC 500. (CONT. on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2026

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-20260420170522

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: WHITE'S ADULT HOME LLC	FACILITY NUMBER: 197609647
	VISIT DATE: 07/10/2026

NARRATIVE

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Interviews were conducted and records were reviewed from 1:30p.m. – 2:30p.m. The investigation revealed that Client 1 (C1) identified in this complaint does not reside at this facility. LPA interviewed two (2) out of four (4) clients in the home. The other clients were out in the community. During interviews, both clients stated they are treated with respect and dignity, and do not know the alleged abuser or the alleged victim. During interviews, all staff stated C1 is not a resident in this home and that S1 works on-call. S1 stated they do not abuse or scratch C1 or any other client they provide care for. S1 confirmed C1 is not a resident at this facility.

Based on interviews and record review, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

No health and safety hazards noted during the visit.

Exit interview conducted and a copy of this report was provided.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:	DATE: 07/10/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/10/2026

LIC9099 (FAS) - (06/04)

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