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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610130
Report Date: 09/17/2025
Date Signed: 09/17/2025 03:07:32 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
09/12/2025 and conducted by Evaluator Mariana Agban
COMPLAINT CONTROL NUMBER: 31-AS-20250912094748
FACILITY NAME:REM CALIFORNIA LLC - BAIRDFACILITY NUMBER:
197610130
ADMINISTRATOR:JONATHAN A WATTSFACILITY TYPE:
735
ADDRESS:10426 BAIRD AVETELEPHONE:
(818) 363-3333
CITY:NORTHRIDGESTATE: CAZIP CODE:
91326
CAPACITY:4CENSUS: 3DATE:
09/17/2025
UNANNOUNCEDTIME BEGAN:
10:05 AM
MET WITH: Okeoghene Marian Okiya- Program Supervisor TIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Licensee did not ensure staff had valid CPR and first aid certifications
Licensee did not ensure staff had on-the-job training as required
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mariana Agban conducted an unannounced initial complaint visit to investigate the above stated allegations. LPA arrived at the facility and was granted access by staff. Administrator Jonathan Watts could not attend today's visit due to an emergency. Program Supervisor, Okeoghene Marian Okiya, came in his place. LPA requested copies of pertinent information, which include, but are not limited to, Staff Roster, Clients Roster, Employee files for Staff #1 (S1), Staff#2 (S2), and Staff#3 (S3) relevant to the investigation. LPA conducted a physical plant tour to ensure the health and safety of the clients are protected and the physical plant complies with Title 22 Regulations.

Allegation: Licensee did not ensure staff had valid CPR and first aid certifications
It was reported that S1, S2, and S3 had expired CPR and first aid certifications. LPA conducted a file review for S1 and observed that S1 had an expired CPR Certificate as of 08/10/24 and issued a new CPR Certificate on 09/03/2025, which confirms that S1 worked without valid CPR and First Aid certification for 13 months. (Continue on 9099C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2025
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 4
Control Number 31-AS-20250912094748
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: REM CALIFORNIA LLC - BAIRD
FACILITY NUMBER: 197610130
VISIT DATE: 09/17/2025
NARRATIVE
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In addition, file review of S2 revealed that S2 had an expired CPR and First Aid Certificate on 10/17/24 and issued a new CPR and First Aid Certificate on 03/02/25, which confirms that S2 worked without a valid CPR and First Aid certification for 4 months. Furthermore, file review of S3 revealed that S3 had an expired CPR Certificate on 07/26/25 and issued a new CPR and First Aid Certificate on 08/05/25, which confirms that S3 worked without valid CPR and First Aid certification for 11 days. Based on the agency review, there was sufficient evidence to confirm the allegation. Therefore, the allegation of Licensee did not ensure staff had valid CPR and first aid certifications, which were deemed Substantiated at this time.

Allegation: Licensee did not ensure staff had on-the-job training as required

It was reported that on-the-job training documentation was missing for several months, spanning August 2024 through August 2025. Interview with the Program Supervisor revealed that facility staff have on-the-job training monthly. LPA conducted a file review of the monthly staff meeting log and observed that there was only documentation of staff training on 09/11/25, 08/14/25, 07/10/25, 05/08/25,04/10/25, and lastly on 03/13/25. There was no documentation for 2024 training's, and from 2025, there were missing the months of January, February, and June. Based on record review, there was sufficient evidence to confirm the allegation. Therefore, the allegation of Licensee did not ensure staff had on-the-job training as required, and is deemed Substantiated at this time.

Exit interview conducted, citations issued, appeal rights given, and a copy of this report signed and delivered.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 31-AS-20250912094748
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: REM CALIFORNIA LLC - BAIRD
FACILITY NUMBER: 197610130
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/17/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/18/2025
Section Cited
CCR
80075(f)
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(f) Staff responsible for providing direct care and supervision shall receive training in first aid from persons qualified by agencies including but not limited to the American Red Cross.This requirement is not met as evidenced by:
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POC is corrected. S1, S2 and S3 had renewed their CPR and First Aid certifications.
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Based on the agency review, and information gathered S1 worked without valid CPR and First Aid certification for 13 months, S2 for 4 months, and S3 for 11 days. This poses as an immediate health and safety risk to the 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: Troy Agard
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 31-AS-20250912094748
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: REM CALIFORNIA LLC - BAIRD
FACILITY NUMBER: 197610130
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/17/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/24/2025
Section Cited
CCR
80065(f)
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All personnel shall be given on-the-job training or shall have related experience which provides knowledge of and skill in the following areas, as appropriate to the job assigned and as evidenced by safe and effective job performance.This requirement is not met as evidenced by:
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The Administrator will provide all staff with training as per the cited regulation. In addition to submitting the training material and staff sign in sheet to CCL for all staff.
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Based on record review, There was no documentation for the 2024 training's, and from 2025, there were missing the months of January, February, and June. This poses a potential health and safety risk to the resident 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: Troy Agard
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4