<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609688
Report Date: 10/22/2024
Date Signed: 10/22/2024 01:29:51 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
10/15/2024 and conducted by Evaluator Lorena Casillas
COMPLAINT CONTROL NUMBER: 31-AS-20241015110150
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:
10/22/2024
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Anderson MunozTIME COMPLETED:
01:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff made sexual comments to resident.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/22/2024 Licensing Program Analyst (LPA) Lorena Casillas conducted an unannounced complaint visit to investigate the above stated allegation. LPA met with Administrator Anderson Munoz and explained the reason for the visit.

LPA Casillas arrived at facility 09:45 am was greeted and granted access by staff. At 10:00 AM LPA Casillas conducted a physical plant tour with Administrator. During the investigation, record reviews were conducted from 10:30 am to 12:00 pm. LPA requested resident roster, LIC 500, Administrator Certificate and Bond Certificate. LPA requested copies of pertinent information relevant to the investigation including but not limited to, resident records, and any other information pertaining to client care. LPA conducted interviews from 12:00 pm to 1:30 pm. with six (6) out of six (6) staff present and one (1) out of four (4) clients that were present and able to communicate with LPA.

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

DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024
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 2
Control Number 31-AS-20241015110150
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: 10/22/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Allegation: Staff made sexual comments to resident.

It is alleged that staff made sexual comments to Client #1 (C1). It is reported that a male staff member was addressing sexual comments with C1. LPA interviewed Administrator who stated that C1 makes sexual comments and wants to engage in sexual conversations with staff. C1 has increased promiscuous behaviors in the recent weeks to the point where staff do not engage in conversations with C1 by themselves. Interviews with six (6) out of six (6) staff present corroborates what Administrator stated and confirmed that C1 has attempted to engage in conversations regarding sexual encounters, but all six (6) staff stated that they redirect or do not engage in such conversations. LPA interviewed C1 and C1 states that they must have been misunderstood because C1 does not feel comfortable talking to anyone about “things like that”. C1 admitted that C1 has made false allegations in the past and that C1 is not able to control this behavior. Therefore, based on observations, record reviews and interviews this allegation is deemed Unsubstantiated.

No citation issued. Exit interview conducted. A copy of this report provided to Administrator.

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

DATE: 10/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2