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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603251
Report Date: 05/16/2025
Date Signed: 05/16/2025 05:08:05 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
10/29/2024 and conducted by Evaluator Tena Herrera
COMPLAINT CONTROL NUMBER: 28-AS-20241029135813
FACILITY NAME:VB CARE HOMESFACILITY NUMBER:
198603251
ADMINISTRATOR:BEVINAHALLI SURESHFACILITY TYPE:
735
ADDRESS:18412 DEL BONITATELEPHONE:
(714) 393-6361
CITY:ROWLAND HEIGHTSSTATE: CAZIP CODE:
91748
CAPACITY:6CENSUS: 5DATE:
05/16/2025
UNANNOUNCEDTIME BEGAN:
02:47 PM
MET WITH:Diego Castillo - CaregiverTIME COMPLETED:
05:15 PM
ALLEGATION(S):
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Staff is administering a felony drug to resident in care.
Staff did not provide adequate supervision resulting in resident sustaining an injury.
Staff did not report incident to CCL.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced compliant visit. LPA met with Diego Castillo and explained the purpose for todays visit.

The investigation consisted of the following:
On 10/31/2024 LPA conducted initial 24hr visit and obtained copies of Staff and Resident Roster along with the medical documents from Client #1's and Face Sheet and Incident reports dated 10/23/24 and 6/20/24. LPA toured facility along side of Mayra Torres and there were no concerns, obstructions, or anything out of the ordinary was witnessed during the visit.From 10/30/24-3/27/25 Investigator L.Garcia with the departments Investigations Bureau conducted an investigation on allegations Staff is administering a felony drug to resident in care and Staff did not provide adequate supervision resulting in resident sustaining an injury. During todays visit LPA investigated allegation Staff did not report incedient to CCL, interviewed administrator Kevin Van Beek and delivered findings. (Continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2025
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 3
Control Number 28-AS-20241029135813
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: VB CARE HOMES
FACILITY NUMBER: 198603251
VISIT DATE: 05/16/2025
NARRATIVE
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The investigation revealed the following:
Allegation: Staff is administering a felony drug to resident in care.
It is alleged that C1 tested positive for fentanyl and due to their cognitive disability there is question as to how C1 was able to get a hold of such drug. Investigator L.Garcia investigated the above allegation. Investigator interviewed 4 staff whom denied the allegation and confirmed that C1 did not have any visitors or
outings leading up to the incident. Medical documents were reviewed and it was revealed during the investigation that C1 was prescribed medications which can lead to a positive test result for fentanyl when tested for narcotics. Therefore, based on the above information, there is insufficient evidence to support the allegation and the allegation is deemed “unsubstantiated”.

Allegation: Staff did not provide adequate supervision resulting in resident sustaining an injury.


It is alleged that C1 suffered a fall which resulted in C1 suffering a brain bleed. Investigator L.Garcia investigated the above allegation. C1's IPP was reviewed and it was revealed that C1 has a history of self-injurious behaviors which include suddenly dropping to the floor without anticipation causing frequent head injuries and banging their head to walls. Investigator interviewed 4 staff and staff reported that nothing unusual was noted and no falls were observed at the time of the incident. The medical records revealed that C1 was diagnosed with a Non-traumatic subdural hemorrhage. However, it was undetermined how, when, or where an injury occurred, since there were no witnesses to the behavior or actions that caused the diagnosis. Therefore, based on the above information, there is insufficient evidence to support the allegation and allegation was deemed “unsubstantiated” .

Allegation: Staff did not report incident to CCL.


It is alleged that facility did not report the incident of C1 testing positive for fentanyl while in the hospital nor the incident of C1 suffering a fall that led to a brain bleed that was determined while at hospital. LPA reviewed SIR's that were submitted to the department on or around the alleged incident date of 10/22/2024 and observed an SIR that was received on 10/23/24 stating the C1 was hospitalized on 10/22/24 due to staff noticing a difference in C1's condition. Administrator confirmed that a call was received to facility and with a mention that there was positive fentanyl reading and head injury that C1 sustained, however, there was no circumstantial evidence to prove the validity of the information provided or that the person on the phone was hospital staff, additionally, there was no paperwork provided to facility from the hospital stating the above information. C1 was no longer in the care of the facility as of 10/23/24 as family took over care of client and client never returned to facility, therefore, there were no updated incident reports provided with the additional information as no information was provided. (Continued on LIC9099-C)
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20241029135813
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: VB CARE HOMES
FACILITY NUMBER: 198603251
VISIT DATE: 05/16/2025
NARRATIVE
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Based on statements and interviews conducted, review of client files and facility file records, 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, and a copy of this report was provided.
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3