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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610130
Report Date: 05/30/2025
Date Signed: 05/30/2025 01:40:17 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 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
05/28/2024 and conducted by Evaluator Mariana Agban
COMPLAINT CONTROL NUMBER: 31-AS-20240528120602
FACILITY NAME:REM CALIFORNIA LLC - BAIRDFACILITY NUMBER:
197610130
ADMINISTRATOR:FREEMAN, ELIZABETHFACILITY TYPE:
735
ADDRESS:10426 BAIRD AVETELEPHONE:
(818) 363-3333
CITY:NORTHRIDGESTATE: CAZIP CODE:
91326
CAPACITY:4CENSUS: 3DATE:
05/30/2025
UNANNOUNCEDTIME BEGAN:
10:04 AM
MET WITH:Okeoghene Marian Okiya-staff TIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Staff are operating out of ratio
Staff are not providing adequate care and supervision to a client
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mariana Agban conducted a subsequent complaint visit to investigate the above allegations. LPA arrived at the facility and was granted access by the staff. Administrator Jonathan Watts was contacted.LPA informed that the Administrator was unable to come due to an emergency. The administrator had assigned staff Okeoghene Marian Okiya to sign today's report.

Allegation: Staff are operating out of ratio
Allegation: Staff are not providing adequate care and supervision to a client

The complainant alleged that staff are not following the Client#1(C1) 1 on 1 ratio as noted from the Regional Center. Furthermore, since there was no 1 on 1 staff, the complainant reports Client#1 (C1 )'s needs are not being met. Interview with the Administrator revealed that C1 had multiple 1:1s, but C1 would fire them or wouldn't work with them. The administrator confirmed that there was difficulty following the 1:1 ratio, as noted from the Regional Center. (Continue on 9099C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025
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-20240528120602
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: REM CALIFORNIA LLC - BAIRD
FACILITY NUMBER: 197610130
VISIT DATE: 05/30/2025
NARRATIVE
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LPA conducted a record review and observed that C1's Individual Program Plan (IPP) states that C1 requires a 1-to-1 support 24 hours per day, 7 days a week. Based on information obtained, the staff were operating out of ratio and did not provide care and supervision to C1. Therefore, the allegations are deemed Substantiated at this time.

Exit interview conducted, citation issued, appeal rights given, copy of this report sign and delivered.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20240528120602
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: REM CALIFORNIA LLC - BAIRD
FACILITY NUMBER: 197610130
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/30/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/03/2025
Section Cited
CCR
85065.5(a)(1)
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For Regional Center clients, staffing shall be maintained as specified by the Regional Center ... This requirement is not met as evidenced by:
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The administrator will schedule vendorized training for all staff by 08/13/25 and submit the vendor information and scheduled training date to CCL. Training certifications to be submitted to CCL upon completion
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Based on interviews and record reviews the facility did not follow 1:1 ratio for C1 and thus staff did not providing adequate care and supervision to C1. This poses/posed a potential health, safety or personal rights risk to persons 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: Eva Miller
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3