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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609704
Report Date: 02/10/2023
Date Signed: 02/10/2023 12:39:55 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
01/27/2023 and conducted by Evaluator Melissa Ruiz
COMPLAINT CONTROL NUMBER: 31-AS-20230127081902
FACILITY NAME:SAFE LAUREL LLCFACILITY NUMBER:
197609704
ADMINISTRATOR:GBOYEGA AKINBOLAFACILITY TYPE:
735
ADDRESS:16300 VINTAGE STTELEPHONE:
(818) 489-1218
CITY:NORTH HILLSSTATE: CAZIP CODE:
91343
CAPACITY:4CENSUS: DATE:
02/10/2023
UNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Angelina OseiTIME COMPLETED:
12:05 PM
ALLEGATION(S):
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Staff are taking clients personal property
Staff speak inappropriately to client
INVESTIGATION FINDINGS:
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On 2/10/2023, Licensing Program Analyst (LPA) Melissa Ruiz arrived at the facility to conduct an unannounced subsequent complaint visit. Upon arrival, LPA was greeted by staff (S2) and an entrance interview was conducted, the purpose of the visit was explained. Administrator designated S2 to sign this report.On 2/2/2023, LPA conducted an initial 10-day visit, where LPA collected relevant documents pertinent to this investigation. On 2/6/2023, LPA conducted interviews with two (2) clients and one staff (S2), and on 2/8/23, LPA interviewed another staff (S2).

Allegations:
Staff are taking clients personal property
Staff speak inappropriately to client

On 2/2/2023, LPA interviewed the Administrator and the Administrator denied knowing of any staff that take C1's personal property such as things in their bedroom or their personal food.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Melissa Ruiz
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023
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-20230127081902
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: SAFE LAUREL LLC
FACILITY NUMBER: 197609704
VISIT DATE: 02/10/2023
NARRATIVE
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Administrator stated that C1 has their personal pantry for their food items and no staff ever use that for all clients. Additionally, Administrator stated that no staff talk inappropriately or rudely ro clients. In fact, C1 is the one who does that, Administrator gave LPA of an example - which was the last Resident Council Meeting on 1/21/23, where C1 was not happy and talked rudely to others.

On 2/6/23, LPA interviewed C1, and C1 stated the Licensee talks about C1 with other staff. C1 also believes that another client, C2 does malicious things like lock them out. An interview with C2 on 2/6/23 revealed that C2 feels comfortable in the home, no issues with staff, and C2 has not witnessed any harassment from staff. C2 also gave an example where C1 spoke inappropriately during a recent resident meeting. LPA interviewed S2 on 2/8/23, and S2 denied both allegations above. Due to interviews conducted and record review, the allegations mentioned above are Unsubstantiated at this time.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Melissa Ruiz
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2