197609781-4-3-2024-31-AS-MVAO-D46VD9-20240409162021

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609781
Report Date: 04/03/2024
Date Signed: 04/03/2024 01:01:04 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
03/19/2024 and conducted by Evaluator Gina Saucedo

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20240319000300

FACILITY NAME:	ZELZAH COMPASSION HOME		FACILITY NUMBER:	197609781
ADMINISTRATOR:	NASSANGA, FATUMA		FACILITY TYPE:	735
ADDRESS:	9200 ZELZAH AVE		TELEPHONE:	(818) 324-9589
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91325
CAPACITY:	4	CENSUS: 3	DATE:	04/03/2024
		UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Stephen Kamukama		TIME COMPLETED:	01:25 PM

ALLEGATION(S):

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Client is being sexually abused while in care
Staff do not meet a client's hygiene needs
Staff do not address a client's change in medical condition
Staff do not seek timely medical attention for a client
Staff do not meet a client's dietary needs
Client is being inappropriately restrained while in care

INVESTIGATION FINDINGS:

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On 04/03/24, at 8:35am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, subsequent complaint visit and was greeted by House Manager, Stephen Kamukama. LPA explained the purpose of this visit was to gather additional information, conduct interviews and deliver findings for this complaint.

On 03/19/2024, LPA Gina Saucedo initiated the complaint investigation. On 03/19/24, LPA conducted a collateral visit at the Career and Transition Center, where the client attends day program. The subsequent visit consisted of the following: LPA Saucedo asked for the census, requested the staff and client roster. At 9:30am, LPA toured the physical plant. During the tour, two (2) additional clients and four (4) staff were interviewed.

LIC 9099C-continued

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024

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-20240319000300

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: ZELZAH COMPASSION HOME	FACILITY NUMBER: 197609781
	VISIT DATE: 04/03/2024

NARRATIVE

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Regarding the allegation: Client is being sexually abused while in care. It is being alleged that the client (C1) is being sexually abused at the group home because the client recently started to perform inappropriate sexual behaviors during school. C1 has been living at the above facility since December 2022 and has two (2) one-on-one staff that are always with C1 at above the facility. There have been no reports of sexual activity since C1’s arrival at the facility. LPA conducted a collateral visit and there was no documentation of any inappropriate sexual behaviors of C1 at the school. In addition, LPA conducted three (3) client interviews where one (1) client was verbal and disclosed no sexual abuse at the above facility. Four (4) out of four (4) staff confirmed that C1 has never had any inappropriate sexual behaviors at home. Therefore, based on the LPA's interviews, observations, and record reviews the above allegation(s) above is UNSUBSTANTIATED at this time.

Regarding the allegation: Staff do not meet a client’s hygiene needs. It is being alleged that the client (C1) comes to day program smelling of bad body odor; thus, being neglected. LPA conducted a collateral visit at the Career and Transition Center where the client spends their day at school. During LPA’s collateral visit, LPA did not observe the clothing on the client to be damaged/torn and there was no odor on C1. LPA also toured C1’s room at the above facility, and the room was in good, clean condition along with their clothing. In addition, LPA conducted three (3) client interviews where one (1) client was verbal and disclosed cleaning is done every day at the above facility. Four (4) out of four (4) staff confirmed that they clean several times out of the day because of the clientele they have. During, LPA's physical tour, LPA observed the other two (2) client rooms to be in clean condition. Therefore, based on the LPA's interviews and observations the above allegation(s) above is UNSUBSTANTIATED at this time.

Regarding the allegation: Staff do not address a client’s change in medical condition. It is being alleged that the client (C1) is diabetic and has gained weight. LPA was able to review the Consumer Identifying Information, Physician’s report, medication list and Individual Program Plan (IPP) where it does not state that the client is pre-diabetic or diabetic. The medication list does not disclose any pre-diabetic or diabetic medication and the medical condition has remained the same since C1’s admission date December 05, 2022. Four (4) out of four (4) staff confirmed that C1’s medical condition has not changed since their arrival at the facility. Therefore, based on the LPA's interviews, observations, and record review the above allegation(s) above is UNSUBSTANTIATED at this time.

LIC 9099C-continued

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20240319000300

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: ZELZAH COMPASSION HOME	FACILITY NUMBER: 197609781
	VISIT DATE: 04/03/2024

NARRATIVE

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Regarding the allegation: Staff do not seek timely medical attention for a client. It is being alleged that the client's (C1) ankles are bad and seem to be getting worse. LPA was able to obtain the last date the client saw the podiatrist, which was July 21, 2023, and obtain a picture of the shoe braces that the client is supposed to wear but refuses too. Four (4) out of four (4) staff confirmed that C1 does not want to wear the shoe braces that were given to them by the podiatrist. Therefore, based on the LPA's interviews, observations, and record review the above allegation(s) above is UNSUBSTANTIATED at this time.

Regarding the allegation: Staff do not meet a client’s dietary needs. It is being alleged that the client is diabetic and is being sent to the program with sweets for their lunch. LPA was able to review the client’s (C1) file at the above facility and there was nothing noted for any special diet. The client’s Individual Program Plan (IPP) states C1’s overall health is good. There are no known allergies to foods or medication and C1 is up to date with their routine medical and dental examinations. Four (4) out of four (4) staff confirmed that C1 does not have and special dietary needs. Therefore, based on the LPA's interviews, observations, and record review the above allegation(s) above is UNSUBSTANTIATED at this time.

Regarding the allegation: Client is being inappropriately restrained while in care. It is being alleged that because the client (C1) is aware of who may be behind them, they are possibly being restrained. LPA was able to review the Special Incident Report (SIR) and the last report was dated in April 2023 where there is no restraining used instead C1 was verbally redirected. Four (4) out of four (4) staff confirmed that speaking to the clients verbally and redirecting them is used first instead of directly using any physical restraining. Therefore, based on the LPA's interviews, observations, and record reviews the above allegation(s) above is UNSUBSTANTIATED at this time.

An exit interview was conducted, no citations were issued for the above allegation(s), and a copy of this report was given to the House Manager.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024

LIC9099 (FAS) - (06/04)

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