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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610252
Report Date: 03/17/2026
Date Signed: 03/17/2026 10:56:33 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
12/10/2025 and conducted by Evaluator Leslie Ngo-Castaneda
COMPLAINT CONTROL NUMBER: 31-AS-20251210095412
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:
03/17/2026
UNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Jay Inciong- RNTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Staff sexually abused a client
Staff are overmedicating the clients
Staff are yelling at the clients.
Staff are mistreating the clients during bathing
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPA) Leslie Ngo-Castaneda conducted a subsequent complaint visit to the facility to investigate the above allegation. LPA met with the facility RN, Jay Inciong, and advised them about the visit.

The Regional Office (RO) received the complaint on 12.10. 2025. On 12/11/25 the complaint was referred and assigned to the Investigations Branch (IB) investigator Douglas Real. On 12.10.2026 at 5:40 PM LPA Ngo-Castaneda conducted a health and safety visit, during which a physical plant tour was conducted to ensure the health and safety of the clients in care. LPA interviewed four (4) clients, the assistant administrator (S1), and four (4) staff from 5:42 PM until 6:28 PM. LPA reviewed the client’s records from 6:30 PM to 6:45 PM and obtained copies of documents related to the investigation, including, but not limited to, staff roster (LIC500), resident roster (LIC 9020), clients’ physicians’ report, admissions agreement, Centrally Stores Medication Destruction Record (CSMDR), Individual Program Plan, and other pertaining documents. Continue to LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026
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 3
Control Number 31-AS-20251210095412
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: 03/17/2026
NARRATIVE
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Regarding allegation: Staff sexually abused a client

It is alleged that facility staff had sexually abused client #1 (C1) by touching C1’s testicles and placing finger in rectum. Interviews with facility staff revealed no evidence that sexual abuse happened during bathing to any of the residents. Staff stated that they ensure they provide their baths in a professional manner. Staff advised and directs the client that their cleaning their private areas gently and without invading the client’s body. Staff baths the clients everyday aside from showers to keep the clients clean and fresh. Interviews with all the clients revealed there have not been occurrences which could be considered sexual abuse by staff toward the clients. Clients believed and stated that they are not being touched inappropriately. IB’s interview and report with C1 revealed the allegation was untrue and has never happened.

Therefore, based on interviews and record review and due to lack of supporting evidence, the allegation is unsubstantiated at this time.

Allegation: Staff are over medicating the clients.

It is alleged that facility staff over-medicated clients in the facility. LPA conducted a record review of all the clients’ medications (CSMDR) and medication records (MAR). Review of clients’ medication (CSMDR), PRN Medication Log, and Medication Administration Record (MAR) reveals that these medications were administered in a timely manner and there were no medications missing for the clients. LPA interviewed clients on 12.10.2025, and it was revealed that clients do not have concerns about being over medicated by facility staff. Interviews with staff revealed that all medications are provided to clients as prescribed.

Therefore, based on interviews and record review and due to lack of supporting evidence, the allegation is unsubstantiated at this time.

Allegation: Staff are yelling at the clients.

It was alleged that facility staff yell at the clients in the facility. During interviews conducted with staff, staff stated they always treat clients with respect and dignity. Staff #1 (S1) added that they would never yell at the clients in care. Staff stated they have not heard their colleagues yell at any of the clients.

Continue to LIC 9099-C

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20251210095412
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: 03/17/2026
NARRATIVE
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Interviews with clients revealed that staff treat them with dignity, respect and they have not been yelled at. Clients stated that they are happy and have not experienced such treatment from staff. During LPA visit, it was observed that the staff spoke to the client in a calm and kind manner.

Therefore, based on interviews and record review and due to lack of supporting evidence, the allegation is unsubstantiated at this time.

Allegation: Staff are mistreating the clients during bathing.

It was alleged that staff are mistreating client #1 (C1) client in care during bath. LPA interviewed five (5) staff that confirmed they have never mistreated their clients while in care. Staff give showers to all of the clients everyday and baths them. LPA interviewed four (4) clients that confirmed they have never been mistreated during their shower and bath time. Clients stated that the allegation is completely false. Interviews with staff revealed staff do not assist C1 with bathing or showers. C1 is completely independent and ambulatory. According to physician report (LIC 602) and IPP C1 is able to bath and shower by themselves.

Therefore, based on the LPA's observations, resident and staff interviews, the above allegation(s) above is UNSUBSTANTIATED at this time.

Exit interview conducted, and a copy of this report was provided.

SUPERVISORS NAME: Mary G Flores
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3