197609924-4-6-2026-31-AS-NGID-DVRMWQ-20260707095842

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609924
Report Date: 04/06/2026
Date Signed: 04/06/2026 12:58:31 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
10/01/2025 and conducted by Evaluator Lorena Casillas

COMPLAINT CONTROL NUMBER: 31-AS-20251001102101

FACILITY NAME:	DIVINE FUTURES IV		FACILITY NUMBER:	197609924
ADMINISTRATOR:	VASHAN BOBNEY		FACILITY TYPE:	735
ADDRESS:	3525 E GARNET LANE		TELEPHONE:	(818) 270-6434
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93535
CAPACITY:	4	CENSUS:	DATE:	04/06/2026
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:			TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Lack of supervision resulting in resident being assaulted by another resident.

INVESTIGATION FINDINGS:

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On 04/06/2026 at 10:00 am Licensing Program Analyst (LPA) Lorena Casillas conducted an unannounced subsequent visit to this facility to investigate the above stated allegation. LPA spoke to the Administrator Anthony Powell and explained the reason for the visit.

On 10/01/2025, the Woodland Hills South Adult and Senior Care Regional Office received a complaint regarding the allegation mentioned above.

On 10/07/2025, LPA Casillas conducted an initial complaint visit. LPA Casillas conducted a tour of the facility and obtained copies of pertinent information. LPA also conducted interviews with the Administrator, the Licensee, five (5) staff and four (04) out of four (04) clients.

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2026

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-20251001102101

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: DIVINE FUTURES IV	FACILITY NUMBER: 197609924
	VISIT DATE: 04/06/2026

NARRATIVE

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Allegation: Lack of supervision resulting in client being assaulted by another client.

It is alleged that lack of supervision resulted in client being assaulted by another client. Regarding this allegation it is reported that Client #1 (C1) was assaulted by Client #2 (C2) because C2 was attempting to flirt with C1’s partner while C1 was on a phone call. It is reported that C2 ran towards C1 and was able to strike C1 in the face. Following C1 being struck in the face, C1 was in crisis, ran out of the facility and proceeded to call 911 for assistance. Subsequently, C1 was taken to the hospital and placed on a psychiatric hold. LPA interviewed House Manager (HM) and it was discovered that both C1 and C2 have partners and C2 was attempting to flirt with C1’s partner. When C1 confronted C2, there was a verbal altercation but at no point did C2 hit or attempt to hit C1. C1 did in fact call 911 and claimed to be in crisis to which the paramedics decided to transport C1 to the hospital where C1 was placed on a psychiatric hold, however this is a common occurrence with C1, and it may or may not be related to this incident. HM did confirm that it was C3 that hit C1 and that it happened so fast that it was unavoidable, not due to lack of supervision. Interview with C1 revealed that it was C3 that struck C1 not C2. C1 stated that it was not lack of supervision as there was enough staff available. It all just happened so fast that it was not preventable. Interview with Staff #1 (S1) over the phone, who was present at the facility when the incident took place, revealed that C2 did not hit or have a physical altercation with C1, only a verbal confrontation. S1 stated that C2 is very good at removing themselves from conflict and would rather return to their room to calm down. Interview with three (3) additional staff revealed that there was no physical altercation between C1 and C2. Interview with Staff #5 (S5) over the phone revealed that there was no lack of supervision, however Client #3 (C3) was the one that hit C1, but it did not go beyond the one hit. S5 stated that C3 was upset that C1 and C2 were arguing but that it did not go beyond a hit before staff intervened and were able to redirect clients. Subsequently C1 had a behavior episode but S5 states that C1 is often in crisis and calls 911 seeking attention. LPA interviewed C2 and C2 stated that they did not hit C1, they only had a verbal argument and C3 was the one to hit C1.

Continued on LIC9099-C

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20251001102101

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: DIVINE FUTURES IV	FACILITY NUMBER: 197609924
	VISIT DATE: 04/06/2026

NARRATIVE

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LPA interviewed C3 who admitted to hitting C1 but that it was because C1 and C2 were loud and annoying. C3 admitted that there were staff present but C3 moved fast and only hit C1 once before staff intervened. Client #4 (C4) stated that although they were in their room and did not witness anything, they did hear that C3 hit C1. All clients confirmed that the staff that was needed to be present were at the facility and that there is no lack of care and supervision. LPA reviewed all client IPPs and found that client needs are being met as far as staff coverage is concerned. LPA also found that C1 does have a history of calling 911 multiple times a day at times possibly for attention. Therefore, based on interviews and record reviews, this allegation is deemed unsubstantiated.

No citation issued. Exit interview conducted. Copy of report provided to Administrator.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:	DATE: 04/06/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2026

LIC9099 (FAS) - (06/04)

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