197609899-9-7-2022-31-AS-NGID-CJMV3H-20220926160447

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609899
Report Date: 09/06/2022
Date Signed: 09/07/2022 12:43:49 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
07/14/2022 and conducted by Evaluator Melissa Ruiz

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20220714130059

FACILITY NAME:	ARCADY VILLA		FACILITY NUMBER:	197609899
ADMINISTRATOR:	CAJAYON, JOJO		FACILITY TYPE:	740
ADDRESS:	44334 LIVELY AVE		TELEPHONE:	(818) 913-2188
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93536
CAPACITY:	6	CENSUS: 6	DATE:	09/06/2022
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Jenny Franoso		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Hazardous chemicals were not kept in a safe and locked place.

INVESTIGATION FINDINGS:

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On 9/7/2022 at 12:00 p.m., Licensing Program Analysts (LPAs) Melissa Ruiz and Evelin Rios arrived at the facility to conduct an unannounced subsequent complaint investigation. The purpose of this visit is to add additional information regarding complaint # 31-AS-20220714130059. Upon arrival, LPAs were granted entrance to the home by a staff. Staff notified the Administrator of the purpose of the visit and Administrator designated staff Jenny to sign this report.

It was alleged that "Hazardous chemicals were not kept in a safe and locked place." This allegation was substantiated on a visit conducted on 7/21/22 by LPAs Ruiz and Stamps. A deficiency was also issued. On 7/21/22, LPAs toured the laundry room with staff and LPAs observed staff unlock the laundry room with the key that is kept hanging next to the laundry room door. LPAs observed laundry detergent and chemicals stored in the laundry room. Due to the key being hung next to the laundry room door, which stores chemicals and detergents, the allegation is substantiated. No deficiencies issued during today's visit. Report signed and delivered.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Melissa Ruiz	TELEPHONE: (818) 401-7980
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2022

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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