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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610252
Report Date: 11/18/2025
Date Signed: 11/18/2025 03:43:47 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
11/14/2025 and conducted by Evaluator Leslie Ngo-Castaneda
COMPLAINT CONTROL NUMBER: 31-AS-20251114094051
FACILITY NAME:FORBES HOMEFACILITY NUMBER:
197610252
ADMINISTRATOR:LUCKY PANAFACILITY TYPE:
735
ADDRESS:9608 FORBES AVE.TELEPHONE:
(626) 926-7186
CITY:NORTHRIDGESTATE: CAZIP CODE:
91343
CAPACITY:4CENSUS: 4DATE:
11/18/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Lucky Pana- AdministratorTIME COMPLETED:
04:10 PM
ALLEGATION(S):
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Staff physically abuses the client.
Staff is mentally abusing the client.
Staff does not provide transportation to resident.
INVESTIGATION FINDINGS:
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At approximately 1:00 PM on 11.18.25, Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted an unannounced complaint visit. LPA met with Administrator (S1), Lucky Pana, and disclosed the reason for the visit. Entrance interview conducted.

Allegation #1: Staff physically abuses the client.

It was alleged that staff physically abused client #1 (C1), by hitting them on their private part. To investigate the allegation above, LPA toured the facility at 1:10 PM and interviewed staff and residents between 1:30 PM and 2:40 PM. At 2:45 PM, LPA conducted a record review of pertinent records, including but not limited to an admission agreement, physician report, IPP, LIC 500 and LIC 9020. Interview with the administrator (S1) revealed that C1 is independent and can shower and change themselves.

Continue to LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
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 2
Control Number 31-AS-20251114094051
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: FORBES HOME
FACILITY NUMBER: 197610252
VISIT DATE: 11/18/2025
NARRATIVE
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During interviews with staff, all staff stated they have never hit, forced, or abused C1 or any of the clients. Staff always handle clients gently and treat all clients with respect. During interviews with clients, three (03) out of four (4) clients stated they are never physically abused by staff and are happy living at the facility.

Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is unsubstantiated at this time.

Allegation #2: Staff is mentally abusing the client.

It was alleged that staff would humiliate client #1 (C1) by showing their body to other people naked while showering. An interview with the administrator (S1) revealed that C1 is independent and can shower and change themselves. At 3:00 PM, when clients used the bathroom, LPA observed that it was locked and closed. LPA did not observe any inappropriate behavior from staff during today’s visit.

Based on interviews and document review, this allegation is deemed Unsubstantiated at this time.

Allegation #3: Staff does not provide transportation to the client.

It was alleged that C1 experienced difficulty in obtaining assistance with transportation to go to church. To investigate this allegation, LPA conducted an interview with the Administrator (S1) and staff members. All parties interviewed denied the above allegation and informed LPA that the facility always has a facility van and a designated drivers are available during every shift, and they never refused any transportation. At 2:45 PM, it was observed that C1 took the public bus going out of the facility instead of asking facility staff to transport them. LPA conducted an interview with three (3) clients, and all clients interviewed expressed no concerns regarding this allegation.

Based on interviews and document review, this allegation is deemed Unsubstantiated at this time.

Exit interview conducted, and a copy of this report signed and delivered.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2