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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610361
Report Date: 04/30/2025
Date Signed: 04/30/2025 02:11:14 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.ASC, 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
10/23/2024 and conducted by Evaluator Melissa Spaeth
COMPLAINT CONTROL NUMBER: 31-AS-20241023112304
FACILITY NAME:LIBERTY RESIDENTIAL FACILITYFACILITY NUMBER:
197610361
ADMINISTRATOR:TILLMAN, WILDA WFACILITY TYPE:
735
ADDRESS:3330 RACQUET LANETELEPHONE:
(661) 916-9090
CITY:PALMDALESTATE: CAZIP CODE:
93551
CAPACITY:4CENSUS: 3DATE:
04/30/2025
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Eric BlancoTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Staff disrupted a client while sleeping
Staff speaks inappropriately to the clients
Staff behavior poses as a risk to the clients
INVESTIGATION FINDINGS:
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On 4/30/2025 Licensing Program Analyst (LPA) Melissa Spaeth conducted a subsequent complaint investigation at the above facility to address the following allegation(s). LPA Spaeth met with the Lead Staff and LPA called the Licensee, Wilda Tillman. LPA explained the purpose of this visit was to deliver the findings.

The investigation consisted of the following: On 10/24/2024 Licensing Program Analyst (LPA) Melissa Spaeth initiated a complaint investigation for the allegation(s) listed above. LPA was greeted by the Administrator. LPA Spaeth interviewed three (3) clients out of four (4) at 10:00 am until 10:15 am. LPA interviewed six (6) out of ten (10) staff members at 11:00 am until 3:45 pm. LPA received a copy of the staff schedule and the staff phone numbers.

Continued on 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Melissa Spaeth
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
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-20241023112304
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: LIBERTY RESIDENTIAL FACILITY
FACILITY NUMBER: 197610361
VISIT DATE: 04/30/2025
NARRATIVE
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Regarding the allegation, Staff disrupted a client while sleeping: It is being alleged a client was sleeping on the couch and a staff member told the client to go to their room. C1 stated they could not remember if this occurred, C2-C3 stated this did not occur, and C4 declined an interview. Two staff members (S1-S2) confirmed this occurred and four staff members (S3-S6) denied this occurred. The Licensee denied the allegation.

Regarding the allegation, Staff speaks inappropriately to the clients: It is being alleged a client stated they did not like the meal that was prepared and a staff member stated the client should cook their own meal. It is also being alleged the staff member also has used inappropriate language and has used racial slurs when addressing clients. C1 stated they could not remember if this occurred, C2-C3 stated this did not occur and C4 declined an interview. S1-S6 and the Licensee unanimously denied this occurred.

Regarding the allegation, Staff behavior poses as a risk to the clients: It is being alleged a staff member has stated to clients they have used illegal drugs. C1 stated they could not remember if this occurred, C2-C3 stated this did not occur and C4 declined an interview. S1-S6 and the Licensee unanimously denied this occurred.

Based upon interviews, the allegations are unsubstantiated.

Exit Interview was conducted and a copy of this report was given.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Melissa Spaeth
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2