197610239-10-22-2025-31-AS-TAGD-DNZQ5W-20251203105235

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610239
Report Date: 10/22/2025
Date Signed: 10/22/2025 11:57:37 AM

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
10/15/2025 and conducted by Evaluator Angelica Segovia

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20251015220815

FACILITY NAME:	DIAMOND CARE FACILITY		FACILITY NUMBER:	197610239
ADMINISTRATOR:	WILDA TILLMAN		FACILITY TYPE:	735
ADDRESS:	1632 AMARGOSA DR.		TELEPHONE:	(661) 526-5371
CITY:	PALMDALE	STATE: CA	ZIP CODE:	93551
CAPACITY:	4	CENSUS: 4	DATE:	10/22/2025
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Wilda Tillman- Administrator		TIME COMPLETED:	12:20 PM

ALLEGATION(S):

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Facility is not following the admission agreement.

INVESTIGATION FINDINGS:

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On 10/22/2025 at approximately 9:00 AM, Licensing Program Analyst (LPA) Angelica Segovia conducted an unannounced initial complaint visit to this facility to investigate the above allegations. LPA was greeted by staff and stated the reason for their visit. Administrator, Wilda Tillman arrived shortly after to assist with today’s meeting.

At 09:05 AM, LPA requested census, clients and staff roster. At approximately 10:00 AM, LPA conducted a physical plant tour, to ensure the health and safety of the clients. At 11:00 AM, LPA requested pertinent documentation pertaining to the investigation such as but not limited to: Admission Agreement, Needs and Services and Staff Schedule. In between 11:30 AM – 12:00 PM, LPA conducted an interview with the Administrator and conducted record review.

(continue to LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Angelica Segovia
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2025

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-20251015220815

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: DIAMOND CARE FACILITY	FACILITY NUMBER: 197610239
	VISIT DATE: 10/22/2025

NARRATIVE

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Regarding the allegation: Facility is not following the admission agreement. It was alleged that the facility’s admission agreement was not followed due to insufficient staffing. To investigate the allegation, LPA conducted record reviews. LPA’s review of records revealed that on 09/15/2025, a Residential and Home and Community-Based Services Waivers (HCBS) Annual review was conducted by North Los Angeles Regional Center (NLARC) staff and during their audit, documentation of staff 24-hour schedule was not made available. On 10/01/2025 an unannounced visit to obtain the requested documentation was conducted by NLARC staff where the documentation revealed the required staff scheduling per the Program Design of 408 hours was not provided but instead only 271 hours were shown to have been provided. This revealed a deficiency of 137 required hours resulting in a Corrective Action Plan (CAP) under Title 17 being issued to the facility on 10/13/2025. However, LPA’s record review of the facility’s Program Design revealed that only a sample schedule showcasing 408 hours was disclosed (page 65). Additional record review of clients’ Admission Agreement confirmed that no set hours of staff scheduling are documented. LPA’s interview with the Administrator stated that their Program Design showcased a sample staff schedule and stated the facility would abide by their Program Design.

Based on record review and interviews, there is not enough information to verify the allegation, therefore the allegation is UNSUBSTANTIATED at this time.

No immediate health and safety issues observed during the day of the visit. Exit interview was conducted and a copy of this report was provided to the Administrator.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Angelica Segovia
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2025

LIC9099 (FAS) - (06/04)

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