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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610105
Report Date: 03/02/2026
Date Signed: 03/02/2026 03:24:41 PM

Substantiated


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
02/21/2026 and conducted by Evaluator Lorena Casillas
COMPLAINT CONTROL NUMBER: 31-AS-20260221152356
FACILITY NAME:MELONIE & JESSIE JAMES JR. ARFFACILITY NUMBER:
197610105
ADMINISTRATOR:LEWIS, JESSICAFACILITY TYPE:
735
ADDRESS:43505 ELITE LANETELEPHONE:
(661) 466-7049
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY:4CENSUS: 2DATE:
03/02/2026
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Jessica LewisTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff yelled at residents
Staff interacted with residents in an inappropriate manner
Staff spoke inappropriately to residents
INVESTIGATION FINDINGS:
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On 03/02/2026 at 10:20 am Licensing Program Analyst (LPA), Lorena Casillas conducted an unannounced complaint visit to investigate the above stated allegations. LPA was greeted and granted access by staff and LPA met with the Administrator Jessica Lewis. LPA explained the reason for the visit. Entrance interview conducted. At 11:00 am, LPA conducted a physical plant tour with the Administrator to ensure the health and safety of the clients are protected.

At approximately 12:00 pm, LPA requested copies of LIC500, Administrator Certificate, Bond and Client Roster. LPA also requested copies of staff training logs, IPP’s, staff training and any documents relevant to the investigation. At approximately 01:30 pm LPA conducted a file review of documents provided. Between 10:20 am and 03:00 pm, LPA conducted interviews with Administrator, one (1) staff and two (2) out of two (2) clients. LPA attempted to interview Client #1 (C1) over the phone, however C1 refused to speak to LPA.

Continued on LILC9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026
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 5
Control Number 31-AS-20260221152356
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: MELONIE & JESSIE JAMES JR. ARF
FACILITY NUMBER: 197610105
VISIT DATE: 03/02/2026
NARRATIVE
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Allegation: Staff yelled at residents.

It is reported that there was an incident on 01/22/26 where Client #1 (C1) was yelled at by Staff #1 (S1) during a verbal altercation. It is further reported that the facility received a Corrective Action Plan (CAP) from North Los Angeles Regional Center (NLARC) where this incident is confirmed as happening by Administrators verbal admission and a written statement from S1 admitting to the incident. This incident was reported to LPA Casillas on 01/23/26 via phone by the Administrator. An SIR was also sent to Community Care Licensing (CCL) reporting the incident. LPA interviewed the Administrator who confirmed that this incident did take place and that corrective measures have been taken since. The Administrator stated that all staff have been retrained on how to handle and deescalate a situation, so that incidents can be better handled moving forward. Regarding this incident the Administrator stated that they were called by NLARC Consumer Services Coordinator (CSC) worker asking to pick up C1 from a bust stop as emergency placement, however, NLARC did not provide C1’s correct information. C1 was not fit for the facility as their diagnoses were not properly disclosed and was later discovered to have been something that the facility was not fit to handle. Administrator states that C1’s severe behaviors were not disclosed and feels like the CSC was purposely deceitful in order to urgently place C1 in a facility. LPA interviewed two (2) out of two (2) clients who stated that they have not been yelled at by anyone at this facility. LPA interviewed S1 and S1 confirmed that the incident did take place, S1 admits to yelling at C1. S1 was placed on administrative leave, from which they have returned, and all staff received mandatory training on personal rights, training on appropriate interaction, boundaries, and deescalation techniques for residents. LPA reviewed CAP, written statement and staff training that have been completed pertaining to this incident and found that these corroborate the allegation. Therefore, based on interviews, observations and record reviews, this allegation is deemed substantiated.

Continued on LIC9099-C

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 31-AS-20260221152356
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: MELONIE & JESSIE JAMES JR. ARF
FACILITY NUMBER: 197610105
VISIT DATE: 03/02/2026
NARRATIVE
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Allegation: Staff interacted with residents in an inappropriate manner.

It is reported that there was an incident on 01/22/26 where Staff #1 (S1) engaged in an argument with Client #1 (C1) which C1 felt was inappropriate. It is further reported that S1 was antagonizing C1 instead of deescalating the situation and that S1 knocked C1’s phone out of C1’s hand. The facility received a Corrective Action Plan (CAP) from North Los Angeles Regional Center (NLARC) where this incident is confirmed as happening by Administrators verbal admission and a written statement from S1 admitting to the incident. This incident was reported to LPA Casillas on 01/23/26 via phone by the Administrator. An SIR was also sent to Community Care Licensing (CCL) reporting the incident. LPA interviewed the Administrator who confirmed that this incident did take place and that corrective measures have been taken since. The Administrator stated that all staff have been retrained on how to handle and deescalate a situation, so that incidents can be better handled moving forward. Regarding this incident the Administrator stated that they were called by NLARC Consumer Services Coordinator (CSC) worker asking to pick up C1 from a bust stop as emergency placement, however, NLARC did not provide C1’s correct information. C1 was not fit for the facility as their diagnoses were not properly disclosed and was later discovered to have been something that the facility was not fit to handle. Administrator states that C1’s severe behaviors were not disclosed and feels like the CSC was purposely deceitful in order to urgently place C1 in a facility. LPA interviewed two (2) out of two (2) clients who stated that staff have not interacted with them in an inappropriate manner. LPA interviewed S1 and S1 confirmed that the incident did take place. S1 admits to interacting inappropriately with C1 by engaging in an argument and knocking C1’s phone out of their hand, however S1 states that this took place after C1 shoved the phone into S1’s nose making S1 react instinctually to deflect injury to their face. S1 was placed on administrative leave, from which they have returned, and all staff received mandatory training on personal rights, training on appropriate interaction, boundaries, and deescalation techniques for residents. LPA reviewed CAP, written statements and staff training that have been completed pertaining to this incident and found that these corroborate the allegation. Therefore, based on interviews, observations and record reviews, this allegation is deemed substantiated.

Continued on LIC9099-C

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 31-AS-20260221152356
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: MELONIE & JESSIE JAMES JR. ARF
FACILITY NUMBER: 197610105
VISIT DATE: 03/02/2026
NARRATIVE
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Allegation: Staff spoke inappropriately to residents.

It is reported that there was an incident on 01/22/26 where Client #1 (C1) was spoken to inappropriately by Staff #1 (S1) during a verbal altercation. It is reported that S1 stated “If you hit me, I will beat your ass”. It is further reported that the facility received a Corrective Action Plan (CAP) from North Los Angeles Regional Center (NLARC) where this incident is confirmed as happening by a written statement from S1 admitting to the incident. This was reported to LPA Casillas on 01/23/26 via phone by the Administrator. An SIR was also sent to Community Care Licensing (CCL) reporting the incident. LPA interviewed the Administrator who confirmed that this incident did take place and that corrective measures have been taken since. The Administrator stated that all staff have been retrained on how to handle and deescalate a situation, so that incidents can be better handled moving forward. Regarding this incident the Administrator stated that they were called by NLARC Consumer Services Coordinator (CSC) worker asking to pick up C1 from a bust stop as emergency placement, however, NLARC did not provide C1’s correct information. C1 was not fit for the facility as their diagnoses were not properly disclosed and was later discovered to have been something that the facility was not fit to handle. Administrator states that C1’s severe behaviors were not disclosed and feels like the CSC was purposely deceitful in order to urgently place C1 in a facility. LPA interviewed two (2) out of two (2) clients who stated that they have not been spoken to inappropriately by staff. LPA interviewed S1 and S1 confirmed that the incident did take place, S1 admits to speaking inappropriately to C1 by making the statement “If you hit me, I will beat your ass”. S1 was placed on administrative leave, from which they have returned, and all staff received mandatory training on personal rights, training on appropriate interaction, boundaries, and deescalation techniques for residents. LPA reviewed CAP, written statements and staff training that have been completed pertaining to this incident and found that these corroborate the allegation. Therefore, based on interviews, observations and record reviews, this allegation is deemed substantiated.

Citations issued. Exit interview conducted. Copy of the report given to the Administrator.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 31-AS-20260221152356
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: MELONIE & JESSIE JAMES JR. ARF
FACILITY NUMBER: 197610105
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/02/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
03/13/2026
Section Cited
CCR
80072(a)(1)
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Personal Rights (a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following (1) To be accorded dignity in his/her personal relationships with staff and other persons. This was not met as evidenced by:
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Administrator and all staff have already completed re-training, proof provided to LPA during visit. This POC is cleared.
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Based on interviews, record reviews and observations, S1 admitted to yelling, arguing and speaking to C1 inappropriately. This poses a potential health and safety risk to clients in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5