197610130-3-19-2026-31-AS-MGFS-DSZVNG-20260410163503

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610130
Report Date: 03/19/2026
Date Signed: 03/19/2026 12:15:21 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
06/28/2024 and conducted by Evaluator Mariana Agban

COMPLAINT CONTROL NUMBER: 31-AS-20240628090950

FACILITY NAME:	REM CALIFORNIA LLC - BAIRD		FACILITY NUMBER:	197610130
ADMINISTRATOR:	FREEMAN, ELIZABETH		FACILITY TYPE:	735
ADDRESS:	10426 BAIRD AVE		TELEPHONE:	(818) 363-3333
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91326
CAPACITY:	4	CENSUS: 3	DATE:	03/19/2026
		UNANNOUNCED	TIME BEGAN:	10:51 AM
MET WITH:	Svetlana Shak- Quality Improvement Specialist		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Facility staff inappropriately restrained client
Facility staff did not prevent client from engaging in self harming behaviors

INVESTIGATION FINDINGS:

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This report supersedes report dated 11/20/25 to correct and provide additional information in the LIC 9099.
Licensing Program Analyst (LPA) Mariana Agban conducted an unannounced subsequent complaint visit. LPA was granted acess by staff and was informed that Administrator Jonathan Watts is not present at the facility. LPA contacted Susan Conk REM Director to explain the reason for the visit. LPA was informed that Administrator is unable to attend today's visit due to health condition. In addition, LPA was informed that Svetlana Shak- Quality Improvement Specialist will be signing today's report on behalf of the Administrator.

On 7/3/24 LPA arrived at the facility and was granted access by Administrator Jonathan Watts. 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. On 11/20/25 LPA obtained copies of Functional Capability Assessment, C3's Routine Body Checks, C3's Admission Agreement, C3's Physician Report, C3's IPP Agreement Form, C3's IPP, C3's 30 day Progress Report dated 06/18/24 (Continue on 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026

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-20240628090950

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: 03/19/2026

NARRATIVE

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C3's 30-day Progress Report dated 07/28/24, C3's SIRs, PCM Crisis Intervention Protocol, C1's physician report, C1's Special Incident Reports (SIRs) , C1's Admission Agreement, C1's behavior plan and Personnel Report. LPA interviewed 1 out of 3 clients. LPA attempted to interview Client 2 (C2) and Client 3(C3). LPA attempted to interview S1 and interviewed 5 staff members.

Regarding the allegation: Facility staff inappropriately restrained client
It was alleged that on March 29, 2024, facility staff performed three restraints on Client #3 (C3). Interview with Regional Center Service Coordinator (SC) revealed the staff involved was a 1:1 agency staff providing services to C3 from 360 Behavioral Health. SC stated that C3 engaged in physical aggression toward staff and self, as well as property destruction. Interview with Administrator Jonathan Watts revealed that he was hired in June 2024 and was not aware of the incident. The Administrator also stated that the facility does not use 360 Behavioral Health to provide services to current clients. LPA interviewed Staff #3 (S3) and Staff #5 (S5), who could not confirm the validity of the allegation. A review of facility records revealed that C3 was admitted to the facility on May 24, 2024. LPA attempted to interview C3 to verify the allegation.
Based on the information obtained, there is insufficient evidence to verify the allegation. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Regarding the allegation: Facility staff did not prevent the client from engaging in self-harming behaviors
It was alleged that facility staff did not prevent Client #3 (C3) from engaging in self-harming behaviors on March 29, 2024. Interview with Regional Center Service Coordinator (SC) revealed the staff involved was a 1:1 agency staff providing services to C3 from 360 Behavioral Health. Interviews conducted with the Administrator, Staff #3 (S3), and Staff #5 (S5) could not validate the allegation. Per staff interviewed when a client is observed having a behavior that can harm themselves, they deescalate clients by redirecting them. Administrator added that the facility employs a Board Certified Behavior Analyst (BCBA) on-site to observe staff interactions with residents, assess staff responses to resident behaviors, and provide guidance to staff in effectively supporting and managing resident behaviors. Record review indicated that C3 was admitted to the facility on May 24, 2024. LPA reviewed all Special Incident Reports (SIRs) pertaining to C3, and there was not an incident report for alleged incident on March 29, 2024 or any incidents pertaining to self-harming behaviors. LPA attempted to interview C3 to verify the allegation. Based on the information obtained, there is insufficient evidence to verify the allegation. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.
Exit interview was conducted with Svetlana Shak- Quality Improvement Specialist and a copy of this report was provided.

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2026

LIC9099 (FAS) - (06/04)

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