197609924-10-20-2025-31-AS-AJWR-DPLQ8N-20251222105702

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609924
Report Date: 10/20/2025
Date Signed: 10/20/2025 03:09:13 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
10/15/2025 and conducted by Evaluator Lorena Casillas

COMPLAINT CONTROL NUMBER: 31-AS-20251015231957

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: 4	DATE:	10/20/2025
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Priscilla Isodora		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Staff did not pick up a client from the hospital in a timely manner.

INVESTIGATION FINDINGS:

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On 10/20/2025, Licensing Program Analyst (LPA) Lorena Casillas conducted an unannounced 10-day complaint visit to the facility to investigate the above allegations. LPA spoke with Administrator Priscilla Isodora and explained the reason for the visit. Entrance interview conducted.

At approximately 10:30 am, LPA requested copies of client and staff rosters. LPA also requested copies of client IPPs, client medical assessments, client hospital paperwork, and any documents relevant to the investigation. At 11:00 am, LPA conducted a physical plant tour to ensure the health and safety of the clients are protected. At approximately 11:30 am LPA conducted a file review of documents provided. Between 10:30 am and 03:00 pm, LPA conducted interviews with Administrator, four (4) staff, and four (4) out of four (4) clients residing at the facility. LPA also conducted phone interviews with hospital staff.

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025

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-20251015231957

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: 10/20/2025

NARRATIVE

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Allegation: Staff did not pick up a client from the hospital in a timely manner.

It is alleged that staff did not pick up a client from the hospital in a timely manner. Regarding this allegation it is reported that Client #1 (C1) was taken to the hospital and was admitted for 3 days because facility refused to pick up C1 sooner. Times and dates were not provided in the report. It is also reported that Administrator and staff would not answer hospital calls to plan to pick up C1 from the hospital. Interview with Administrator revealed that C1 was admitted to the hospital on 10/10/25 on a psychiatric hold, was released on 10/13/25 and returned via ambulance to the facility, then C1 was readmitted on 10/13/25 at 11:13 pm, released on 10/14/25 at 1:19pm and picked up by staff. C1 was readmitted on 10/14/25 at 3:06 pm, released on 10/14/25 at 3:33 pm and picked up by staff. C1 was readmitted on 10/14/25 at 9:24pm released on 10/15/25 at 5:37 am and dropped off by Uber. According to Administrator, at no point was there a refusal to have C1 return to the facility as proven by C1 returning sometimes twice in a day to the hospital from the facility. Furthermore, it was stated by Administrator that C1 was returned to the facility from the hospital by either staff picking C1 up or by having the hospital arrange for C1 to be transported via ambulance and/or Uber. Administrator states that a call was made by hospital to Administrator which went answered and transportation arrangements were confirmed, Administrator denies that calls went unanswered by Administrator or staff. Interview with C1’s one on one (1:1) revealed that on 10/15/25 1:1 met with C1 at the hospital and confirmed that C1 was returned to the facility by an Uber as 1:1 also rode with C1 in the vehicle. Interview with three (3) out of (3) staff corroborated statements made by the Administrator confirming that C1 was either picked up by staff or dropped off by hospital arranged transportation, more specifically on 10/13/25 C1 was returned via ambulance, an arrangement made by the hospital upon doctors ok to discharge C1. Interview with C1 confirmed that at no time did the facility refuse to pick C1 up, C1 also confirmed that the hospital also made arrangements to drop C1 off when C1 was released on 10/13/25 and on 10/15/25. C1 states that on 10/13/25 and 10/14/25 staff picked C1 up from the hospital. Interview with two (2) additional clients revealed that at no time have they ever experienced the facility refusing to pick them up when they have needed transportation.

Continued on LIC9099-C

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20251015231957

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: 10/20/2025

NARRATIVE

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LPA reviewed hospital discharge paperwork, and it was discovered that the dates and times provided by Administrator are in fact reflected in discharge paperwork. LPA Casillas spoke with Olive View Mental Health Clinical Supervisor for the Psychiatric Emergency Department, and it was confirmed that C1 was there for three (3) days 10/10/25 to 10/13/25 on a seventy-two hour (72) psychiatric hold and was released when attending physician deemed C1 to be ready for release. It was also stated that according to hospital policy all patients that are released by the psychiatric emergency department to a licensed facility or group home are to be transported by ambulance only back to the facility, the facility could not have refused to pick up C1 as they would not have been able to pick up C1 per policy. Clinical Supervisor also stated that a call was made to the facility Administrator to arrange for staff to be present at the facility so that C1 could be dropped off and that the call was answered and arrangements were confirmed. Therefore, based on interviews, record reviews and observations 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: 10/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2025

LIC9099 (FAS) - (06/04)

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