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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600915
Report Date: 12/21/2022
Date Signed: 12/21/2022 12:05:04 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
08/30/2021 and conducted by Evaluator LaQueena Lacy
COMPLAINT CONTROL NUMBER: 31-AS-20210830105453
FACILITY NAME:D4, INC.FACILITY NUMBER:
198600915
ADMINISTRATOR:FRANCISCO ESPINOZAFACILITY TYPE:
735
ADDRESS:4541 N FIGUEROA STTELEPHONE:
(323) 223-1221
CITY:LOS ANGELESSTATE: CAZIP CODE:
90065
CAPACITY:100CENSUS: 98DATE:
12/21/2022
UNANNOUNCEDTIME BEGAN:
10:57 AM
MET WITH:Ruby FloresTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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9
Facility failed to provide safe environment for resident.
Resident exposed himself to a resident.
Residents are using drugs at the home.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) LaQueena Lacy conducted a subsequent compliant visit on 12/21/2022 at 10:42am to investigate the above allegations. LPA met with staff Ruby Flores and explained the purpose of the visit.
LPA conducted a physical plant tour at 10:51am.

It is alleged that client #1 (C1) was starting fights with other clients. To investigate the above allegation LPA interviewed clients and staff on 10/19/2022 at approximately 12:18pm. Additional interviews conducted with staff on 12/21/2022 at 11:22am. Interviews with seven (07) out of (07) clients determined, they have not witnessed any altercations or fights between any male or female clients and affirm that the facility provides a safe environment for them, and they feel safe. During the investigation staff confirmed that no clients have reported any altercations or fights between any clients. Based on LPAs interviews and observation, there is not enough evidence to support the allegation, therefore the allegation is UNSUBSTANTIATED.
Continued on LIC9099C

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: LaQueena Lacy
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022
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-20210830105453
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: D4, INC.
FACILITY NUMBER: 198600915
VISIT DATE: 12/21/2022
NARRATIVE
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#2. Resident exposed himself to a resident.

It is alleged that C1 exposed themself to another client. Interviews with seven (07) out (07) clients revealed they have not witnessed anyone exposing themself and they have not been told by any client that someone exposed themself. During the investigation interviews with staff confirmed they have not witnessed any client exposing themself, or been told of any client exposing themself in any common areas. Based on LPAs interviews and observation, there is not enough evidence to support the allegation, therefore the allegation is UNSUBSTANTIATED.

#3. Residents are using drugs at the home.

It is alleged that C1 started doing crack cocaine. Interviews with seven (07) out (07) clients revealed they have not witnessed any clients doing crack cocaine at the facility. Staff interviews confirmed, they have not witnessed any clients doing crack cocaine and have not been told by any other clients of anyone using crack cocaine. Based on LPAs interviews and observation, there is not enough evidence to support the allegation, therefore the allegation is UNSUBSTANTIATED.

Exit interview conducted, copy of report and appeal rights issued.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: LaQueena Lacy
LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2