197609683-10-6-2022-31-AS-RRAZ-CKJKZP-20221025082103

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609683
Report Date: 10/06/2022
Date Signed: 10/06/2022 03:34:56 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
03/07/2022 and conducted by Evaluator Tuesday Cabiness

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20220307113017

FACILITY NAME:	LONE STAR BOARD & CARE TUJUNGA		FACILITY NUMBER:	197609683
ADMINISTRATOR:	ALEXANDER, OTIS		FACILITY TYPE:	735
ADDRESS:	10117 TUJUNGA CANYON BLVD		TELEPHONE:	(818) 875-4501
CITY:	TUJUNGA	STATE: CA	ZIP CODE:	91042
CAPACITY:	35	CENSUS: 26	DATE:	10/06/2022
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Rod Stinson & Gio Monico		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff pushed client

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Tuesday Cabiness and Tihesha Smith conducted a subsequent visit to deliver the final findings of the allegation mentioned above. LPA(s) met with Co-Aministrator Rod Stinson and Facility Manager Gio Monico, who were informed the reason of the visit. The following was determined:

It was alleged staff pushed client #1 (C1). LPA conducted interviews on 03/11/2022, 03/14/2022, 03/15/2022, and 10/06/2022, from various times of the day, ranging from 8am to 4pm with the complainant, clients and facility staff. Information obtained through those interviews, revealed there were no witnesses to corroborate that staff pushed C1. Although there were previous incidents with C1, there is a lack of supportive evidence to indicate C1 was pushed by staff. Therefore, based on interviews, the allegation is UNSUBSTANTIATED at this time.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2022

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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