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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603115
Report Date: 11/03/2022
Date Signed: 11/03/2022 03:58:50 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/27/2022 and conducted by Evaluator Alma Gonzalez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20221027123926
FACILITY NAME:SEIDE'S FAMILY AFFAIRFACILITY NUMBER:
198603115
ADMINISTRATOR:KHABERR, NIJIHFACILITY TYPE:
735
ADDRESS:11046 LEIBACHER AVETELEPHONE:
(562) 202-4477
CITY:DOWNEYSTATE: CAZIP CODE:
90241
CAPACITY:4CENSUS: 3DATE:
11/03/2022
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Nijih KhabeerTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Resident sustained a bruise while in care.
Facility staff hit resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced complaint visit to gather information pertaining to the above-mentioned allegations. LPA met with Administrator Nijih Khabeer and explained the reason for the visit.

The investigation consisted of: LPA conducted interviews with Administrator Nijih Khabeer , Staff 1-2 (S1-2), Clients 1-2 (C1-2), Independent Steps Program Director Margarita Sanchez by telephone and attempted a phone call to South Central Los Angeles Regional Center (SCLARC) Service Coordinator (SC) Adrian Diaz. C3 and S3 were not interviewed as they were not at the facility during the time of LPA's visit. LPA obtained copies of Staff and Client Rosters. LPA reviewed C1's facility file and collected copies of C1's Individual Service Plan dated (8/2022) and 4th Quaterly Progress Report dated 8/17/22.


(See LIC9099C for continuation)
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Alma Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
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 28-AS-20221027123926
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: SEIDE'S FAMILY AFFAIR
FACILITY NUMBER: 198603115
VISIT DATE: 11/03/2022
NARRATIVE
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Investigation revealed the following: Regarding allegations, Resident sustained a bruise while in care and Facility staff hit resident, it is alleged that a facility client is a victim of physical abuse at the facility and had a significant bruise on their eye. When client was asked what happened they allegedly stated that they were punched on the eye for not wanting to brush their teeth by a facility staff. The alleged bruising was alleged to be on the client's eye. Interviews conducted with 4 out of 4 facility staff revealed that facility staff have never hit any facility client and they also denied that any facility client had bruising on their eyes, anywhere on their face or anywhere else on their bodies. Facility staff denied ever causing any physical harm to any facility client and stated that they assist and care for clients on a daily basis and would never hurt them. S1-2 stated that they have never hit any client or heard any other staff hitting any client. They also stated that they did not observe any bruising on any of the clients. Administrator Kahbeer stated that there was a reported incident last week (10/24/22) in which a transportation staff for C1 reported to staff at C1's day program that they had observed bruising under C1's eye and that C1 allegedly told the driver that it happened when C1 did not brush their teeth "fast enough" and S3 was the alleged perpetrator. Administrator stated that S3 and C1 have a good relationship and that S3 cares very well for all clients. Administrator stated that they are not sure as to why the driver would report something like that and stated that she had been in contact with Independent Steps Day Program Staff regarding this incident. LPA interviewed Independent Steps Program Director Margarita Sanchez who stated that C1 did not have any bruising on their face or anywhere else on 10/24/22 when the report was made by the transportation company. Interview with C1 revealed that they did not have a bruise and that staff have never hit them or any other client at the facility. C2 stated that staff have never hurt them, hit them or caused bruising on their body. C1-2 stated that they are happy at the facility and they do not have any concerns. They stated that staff treat them well, take good care of them and help them whenever they need assistance. C1-2 both stated that if anyone would ever treat them in an abusive manner they would immediately report such incidents to their family and to SCLARC. LPA review of C1's Individual Service Plan and 4th Quarterly Progress Report revealed that one of C1's behaviors is fabrication of stories. During LPA's visit, LPA observed that both clients interacted well with Administrator, and S1-2 and also observed staff tend to the clients when needed. Both clients appeared safe and LPA did not observe any bruising on C1-2. Based on LPA review of documents, statements gathered from interviews conducted with staff and clients and LPA observations there was not enough supportive evidence to concur with the reported allegations.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview held. A copy of the report was provided to Staff Joy Ogbomo
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Alma Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2022
LIC9099 (FAS) - (06/04)
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