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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600915
Report Date: 08/01/2024
Date Signed: 08/01/2024 02:30:47 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.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
12/01/2023 and conducted by Evaluator Jose Gary Tan
COMPLAINT CONTROL NUMBER: 31-AS-20231201162001
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: 93DATE:
08/01/2024
UNANNOUNCEDTIME BEGAN:
09:13 AM
MET WITH:Ruby Flores - Assistant AdministratorTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff yell at residents
Staff do not prevent resident from sexually abusing other residents
Staff do not prevent residents from being physically abused by other residents
Staff mismanage residents’ medications
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Gary Tan conducted an unannounced subsequent complaint visit at this facility to further investigate the above allegations. LPA met with Assistant Administrator Ruby Flores and explained the reason for the visit.

LPA conducted physical plant tour at 9:35 AM, requested copies of facility documents relevant to the investigation at 10:05 AM and interviewed additional staff and residents between 10:30 AM to 1:00 PM. Regarding the allegation that staff yells at residents, it was alleged that Staff #1 (S1) yells and swears at residents. LPA's interview with a total of nine (9) residents on 12/05/23 between 10:38 AM to 1:00 PM and on 07/11/24 between 11:15 AM to 1:00 PM or 10% of current census revealed that nine (9) out of nine (9) residents were not yelled at by S1 nor witnessed S1 yelled or cussed at any resident of the facility.

(continued on LIC 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
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-20231201162001
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: D4, INC.
FACILITY NUMBER: 198600915
VISIT DATE: 08/01/2024
NARRATIVE
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Regarding the allegation that Staff do not prevent resident from sexually abusing other residents, it was alleged that Resident #2 (R2) frequently sexually assaults female residents by putting arm around them, touching their breasts, and “putting his tongue down their throats” and asked the Reporting Party (RP) twice to give R2 “hand jobs” and “blow jobs” in exchange for the key to the laundry room. RP did not provide any identifier nor any contact information, so no contact was made to RP and LPA was not able to verify nor get the details of this allegation. LPA's interview with the administrator today however, verified that R1 was not an employee but a resident (R2) who volunteered to work and not paid by the facility. R2's main function was to help the kitchen staff bring in groceries and stock them in the kitchen every Wednesday and Friday and R2 was never given the key to the laundry room nor was R2 in charge of the laundry room. Further, the assistant administrator did not receive any report of any sexual assault by R2 to anyone at any time since R2 was admitted at this facility. LPA's interview with R2 on 07/11/24 at 12:35 PM confirmed R2's volunteer work at the kitchen and not being paid for R2's voluntary work. R2 also denied having a key or being in charge of the laundry room. Further interview also revealed that R2 has a current relationship with another resident for about a year now and denied touching or sexually assaulting any one at the facility.

Regarding the allegation that Staff do not prevent residents from being physically abused by other residents, it was alleged that Resident #3 (R3) was attacking other residents. LPA's record review today between 1:00 PM to 1:45 PM revealed that R3 was admitted at the facility on 04/03/23 and was arrested on 07/25/23 for assaulting a police officer outside the facility and never came back. LPA's interview with the Assistant Administrator revealed R3 never had any report of physical altercation nor abused any other resident at the facility but had a violent encounter outside of the facility in a nearby grocery store.

Regarding the allegation that Staff mismanage residents’ medications, it was alleged that Medication Technician staff frequently dispense the wrong medications to residents. LPA's record review today between 1:00 PM to 1:45 PM revealed that there was no medication error on record for the last twelve (12) months. LPA's interview with the Assistant Administrator today also revealed that there was no report of medication error that she could recall. LPA's interview with a total of nine (9) residents on 12/05/23 between 10:38 AM to 1:00 PM and on 07/11/24 between 11:15 AM to 1:00 PM or 10% of current census revealed that nine (9) out of nine (9) residents did not experience being given the wrong medication nor witnessed any other resident being given the wrong medication.

Based on the information gathered during this and prior visits, these allegations are deemed unsubstantiated at this time. Exit interview conducted. Copy of this report issued.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
LIC9099 (FAS) - (06/04)
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