197610112-8-11-2025-31-AS-TAGD-DM3N4F-20251002100751

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610112
Report Date: 08/11/2025
Date Signed: 08/11/2025 02:09:32 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
08/03/2025 and conducted by Evaluator Gina Saucedo

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20250803132124

FACILITY NAME:	CREBS COMPASSION HOME		FACILITY NUMBER:	197610112
ADMINISTRATOR:	MOSES T BAHINGIRE		FACILITY TYPE:	735
ADDRESS:	9343 BALCOM AVE		TELEPHONE:	(818) 324-9589
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91325
CAPACITY:	4	CENSUS: 4	DATE:	08/11/2025
		UNANNOUNCED	TIME BEGAN:	09:55 AM
MET WITH:	Alex Gulisi, Caregiver		TIME COMPLETED:	02:10 PM

ALLEGATION(S):

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Staff did not provide adequate care and supervision to residents resulting in resident wandering away from the facility

INVESTIGATION FINDINGS:

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On 08/11/25, at 9:55am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, initial complaint visit and was greeted by Alex Gulisi, Caregiver. LPA explained the purpose of this visit was to gather information, interview staff and clients and deliver findings for this complaint.

On 08/11/25, at 10:30am, LPA Saucedo asked for the census, staff, and client rosters. At 10:50am, LPA Saucedo conducted a physical tour and interviewed staff.

LIC 9099C-continued

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2025

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-20250803132124

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: CREBS COMPASSION HOME	FACILITY NUMBER: 197610112
	VISIT DATE: 08/11/2025

NARRATIVE

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Regarding the allegation: Staff did not provide adequate care and supervision to residents resulting in resident wandering away from the facility. It is being alleged that there was not adequate care and supervision for client #1 (C1). LPA spoke to staff #1 (S1) who confirmed that C1 has two (2) one on one staff for care and supervision. The morning of 08/01/25 when C1 pushed out the window and wandered away, C1 asked for privacy and closed their door. S1 stated anytime a client asks for privacy, it is to be given to them because it's their right. When Staff #2 (S2) did their fifteen (15) minute check and opened C1's door, C1 had climbed out of their bedroom window. S2 also confirmed that at the time C1 had climbed out their window was around midnight. S2 then notified staff # 3 (S3) right away who is C1's other one on one staff and the police were notified along with other staff members to start looking for C1. Staff # 4 (S4) confirmed that they were driving around the neighborhood looking for C1 along with other staff members when the police notified them that C1 was at the Northridge Hospital. S4 went to go pick up C1 at Northridge Hospital but C1 was not being released to the above facility until C1's father came to pick them up. C1's father did not pick up C1 until around the morning hours of 8:00am or so. S1 confirmed that C1's family was notified immediately around 1:00am or so but no one had picked up the phone and North Los Angeles County Regional Center was also notified of the incident. Community Care Licensing also received an Unusual Incident Report of the incident. During LPA's physical tour, LPA observed the window that C1 had jumped from. In addition, at the time of the visit, C1 had two (2) one on one staff with them. LPA attempted to interview C1 but C1 did not understand what LPA was asking. Let it be noted, C1 is diagnosed with Mild Intellectual Disability. LPA also obtained C1's Individual Program Plan. Therefore, based on the LPA's observations, record review and staff and individual interviews, the above allegation(s) above is UNSUBSTANTIATED at this time.

An exit interview was conducted, no citation(s) were issued, and a copy of this report was given to the Administrator..

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 08/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2025

LIC9099 (FAS) - (06/04)

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