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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609688
Report Date: 01/29/2024
Date Signed: 01/29/2024 12:55:21 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
01/04/2024 and conducted by Evaluator Lorena Casillas
COMPLAINT CONTROL NUMBER: 31-AS-20240104150734
FACILITY NAME:ZION ETERNITY RESIDENTIALFACILITY NUMBER:
197609688
ADMINISTRATOR:ANDERSON MUNOZFACILITY TYPE:
735
ADDRESS:43642 DANA DRTELEPHONE:
(818) 687-3830
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY:4CENSUS: 4DATE:
01/29/2024
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Anderson MunozTIME COMPLETED:
01:10 PM
ALLEGATION(S):
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Unlawful eviction.
Staff are withholding resident's P&I money.
Staff do not treat residents with dignity and respect.
INVESTIGATION FINDINGS:
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On 01/29/2024 at 12:30 pm Licensing Program Analyst (LPA) Lorena Casillas conducted an unannounced subsequent complaint visit to deliver the findings for the above allegations. LPA met with the Administrator Anderson Munoz and explained the reason for the visit.

On 01/10/24 LPA Casillas conducted an initial 10-day complaint visit. During the course of the investigation LPA was able to gather information pertaining to the allegations. On that day LPA conducted a tour of the facility, interviewed with facility staff and obtained copies of pertinent information related to the allegation.

Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
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 3
Control Number 31-AS-20240104150734
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: ZION ETERNITY RESIDENTIAL
FACILITY NUMBER: 197609688
VISIT DATE: 01/29/2024
NARRATIVE
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Allegation #1 Unlawful eviction.

It was alleged that the facility unlawfully evicted Client #1 (C1). During the investigation LPA Casillas contacted North Los Angeles Regional Center (NLARC) staff Consumer Services Coordinator for C1. In interviewing NLARC staff it was determined that C1 was not evicted, but instead was placed in a higher care facility with the ability to care for C1. In interviewing Administrator, he explained that C1 was not evicted. C1 was placed on a medical hold due to behavior and was to be placed into another facility with higher care by NLARC staff. Shortly after a new client was sent to Zion Eternity by NLARC filling the capacity. During this investigation LPA was able to gather additional information and learned that the resident was never going to be evicted, LPA verified through interviews that the facility never had intentions of evicting the resident. LPA reviewed files at the facility and there were no written notices on file regarding the eviction of a resident.

Based on the inspection, observation and record review, there is not sufficient information to verify the allegation. Therefore, the allegation is deemed Unsubstantiated.

Allegation #2 Staff are withholding resident's P&I money.

It was alleged that staff are withholding clients’ P&I money. During the investigation LPA was able to contact third party Foundation for Advocacy Conservatorship and Trust, Inc. (FACT) and they were able to confirm that the facility has not received any funds after July 2023 for Client #1 (C1). FACT is an approved vendor for North Los Angeles Regional Center that handles clients’ funds. Funds sent out after July 2023 have been sent to C1’s mother. LPA gathered copies of the ledger and was able to discover that the facility uses funds from their own house funds to cash advance clients so that they are not left without any money. LPA observed that all funds that were sent to the facility by FACT were accounted for and that clients spent their money on food and other items.



Based on the inspection, observation and record review, there is not sufficient information to verify the allegation. Therefore, the allegation is deemed Unsubstantiated.

Continued LIC9099-C

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20240104150734
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: ZION ETERNITY RESIDENTIAL
FACILITY NUMBER: 197609688
VISIT DATE: 01/29/2024
NARRATIVE
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Allegation #3 Staff do not treat residents with dignity and respect.

It was alleged that staff do not treat residents with dignity and respect. The allegation states that staff have been instructed to ignore clients in care. During the interviews with staff LPA learned that staff did not ignore clients, however they do not speak to them alone and seek other staff to be present during all conversations. Clients are given funds from the housing funds so that they are not left out while going on outings, further confirming that staff included all clients in facility activities.

Based on the inspection, observation and record review, there is not sufficient information to verify the allegation. Therefore, the allegation is deemed Unsubstantiated.

Exit Interview conducted. A copy of this report was given to the Administrator.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3