197610137-2-1-2023-31-AS-NMAN-CP9UNJ-20230221144402

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610137
Report Date: 02/01/2023
Date Signed: 02/01/2023 12:27:29 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
06/16/2021 and conducted by Evaluator Nicholas Reed

COMPLAINT CONTROL NUMBER: 31-AS-20210616115735

FACILITY NAME:	REM CALIFORNIA LLC - OSBORNE		FACILITY NUMBER:	197610137
ADMINISTRATOR:	IBRAHIM, MOSHOOD		FACILITY TYPE:	735
ADDRESS:	15952 OSBORNE ST		TELEPHONE:	(818) 893-1234
CITY:	NORTH HILLS	STATE: CA	ZIP CODE:	91343
CAPACITY:	4	CENSUS: 4	DATE:	02/01/2023
		UNANNOUNCED	TIME BEGAN:	11:50 AM
MET WITH:	eucharia omoruyi		TIME COMPLETED:	12:32 PM

ALLEGATION(S):

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Residents are forced to stay in their rooms.
Residents are forced to sleep.
Residents are not provided activities.
Resident is not awarded privacy.

INVESTIGATION FINDINGS:

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At 11:50 a.m. on 02/01/2023, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced subsequent complaint visit. LPA met with staff and disclosed the reason for the visit. At 12:20 p.m. the Administrator confirmed that staff can sign today's licensing reports in his absence.

LPA Martina Berry conducted an initial visit at 2:10 p.m. on 06/18/2021. LPA Berry toured the physical plant and interviewed clients and staff from 2:45 p.m. to 3:00 p.m. LPA Reed conducted a file review at 8:00 a.m. on 01/23/2023 and a subsequent visit at 1:45 p.m. on 01/23/2023. LPA Reed interviewed clients and staff from 2:15 p.m. to 2:45 p.m., toured the physical plant at 2:45 p.m., and conducted a record review at 3:00 p.m. LPA Reed conducted additional staff interviews at 5:05 p.m. on 01/23/2023 and at 11:32 a.m. on 01/30/2023.

Regarding the allegation “Residents are forced to stay in their rooms”, it was alleged Staff #1 (S1) forced Client #1 (C1) to stay in their room and C1 was not allowed out.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

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-20210616115735

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: REM CALIFORNIA LLC - OSBORNE	FACILITY NUMBER: 197610137
	VISIT DATE: 02/01/2023

NARRATIVE

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From interviews, C1 stated staff do not make clients stay in their rooms. S1 stated clients are not forced to stay in their rooms. Other facility staff confirmed that clients are not forced to stay in their rooms. Staff #2 (S2) noted clients would only be advised to go to their rooms in the event of a dangerous behavioral episode or for COVID isolation. S2 also noted C1’s history of fabricating events that did not happen. From file review, there was a pattern of unsubstantiated allegations from C1 from July 2021 to October 2021. Based on interviews and file review, although the allegation may have happened or is valid, there is insufficient evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.
Regarding the allegation “Residents are forced to sleep”, it was alleged S1 forced C1 and two other clients to go to sleep. From interviews, C1 and Client #2 (C2) stated they have not been forced to go to bed. S1 and S2 also confirmed that staff did not force clients to go to sleep. Based on interviews, although the allegation may have happened or is valid, there is insufficient evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Regarding the allegation “Residents are not provided activities”, it was alleged S1 did not allow C1 to go outside to play. Additionally, C1’s time at church was limited. From interviews, S1 stated activities are provided to clients based on their preferences. C1 did attend church but had to leave early due to a behavioral episode. S2 stated C1 has refused activities which were offered and did not suggest their preferred activities. C1 told LPA they attended church with staff on 01/22/2023. C1 likes to play ball and watch baseball on the television. LPA observed C2 and Client #3 (C3) playing basketball outside with staff at 3:00 p.m. on 01/23/2023. Based on interviews and observations, although the allegation may have happened or is valid, there is insufficient evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Regarding the allegation “Resident is not awarded privacy”, it was alleged staff listen in on C1’s phone calls. From interviews, C1 stated staff do not listen to their phone calls. S2, Staff #3 (S3), and the Administrator noted staff provide privacy during client phone calls. Most clients use the house phone in the living room, but C1 has their own phone in their room. Staff encourage clients to use the phone in their rooms. Based on interviews, although the allegation may have happened or is valid, there is insufficient evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Exit interview conducted. Appeal rights discussed. Copy of report provided.

SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2023

LIC9099 (FAS) - (06/04)

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