198603289-7-7-2025-28-AS-WSHO-DJWT7S-20250725142911

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603289
Report Date: 07/07/2025
Date Signed: 07/07/2025 03:13:52 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, 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
06/27/2025 and conducted by Evaluator Nune Margaryan

COMPLAINT CONTROL NUMBER: 28-AS-20250627161708

FACILITY NAME:	KAISER BEHAVIORAL CENTER WEST COVINA		FACILITY NUMBER:	198603289
ADMINISTRATOR:	MEJIA, VANESSA		FACILITY TYPE:	775
ADDRESS:	1532 AMAR ROAD STE B		TELEPHONE:	(626) 945-0790
CITY:	WEST COVINA	STATE: CA	ZIP CODE:	91790
CAPACITY:	75	CENSUS: 33	DATE:	07/07/2025
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Vanessa Mejia, Program Manager		TIME COMPLETED:	02:35 PM

ALLEGATION(S):

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Staff did not prevent client from being bullied.
Staff shared video of client being bullied.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nune Margaryan conducted an unannounced initial 10-Day complaint investigation regarding the above allegation. LPA meet with Vanessa Mejia who assist with the visit. The purpose of the visit was explained.

The investigation consisted of the following: Obtained copies of Staff & Clients Rosters, interviewed Staff 1 to Staff 4 (S1 to S4), Client 1 to Client 4 (C1 to C4), Family Member 1 and Family Member 2 (FM1 and FM2). S1 and S4 were interviewed over the phone. LPA also obtained the copies of relevant documents.

Continue 9099C

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Nune Margaryan
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/07/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20250627161708

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: KAISER BEHAVIORAL CENTER WEST COVINA	FACILITY NUMBER: 198603289
	VISIT DATE: 07/07/2025

NARRATIVE

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Investigation revealed the following: Regarding allegations Staff did not prevent client from being bullied and Staff shared video of client being bullied. It was alleged that S1 was showing videos of C1 being bullied.

Staff interviews revealed that staff treat clients with dignity and respect, and they do not bully anyone. Staff interviews revealed that staff have not witnessed S1 or any staff bully C1 or other clients. Interviewed staff didn’t witness that C1 was being bullied by another client. Interviewed staff stated that they didn't take the videos of clients and didn't witness that S1 take a video of C1 or others and/or showed any videos that C1 was bullied by the staff or another client. Interviewed staff indicated they are trained in zero tolerance, mandated reporting and client rights. Interviewed S2 indicated that S1 on administrative leave for now and Police Report was filed with Covina PD and West Covina PD. Police officer names and report number were provided to LPA. Interviews conducted with FM1 and FM2. FM1 and FM2 stated that C1 was bullied at the Day Program and the video was shared with family friends by S1. On LPA's question what they see in the video, FM1 and FM2 stated that they didn't see the video and didn't provide any specific / detailed information about the video. Interviewed clients revealed that staff treat them with dignity and respect. They indicated that staff does not bully anyone. C1 when asked by LPA that S1 or other staff took the video of them, C1 did not mention being video recorded. During the interview C1 was asked again if they were video recorded by S1 or other staff, C1 said no. Interviewed clients stated that they feel safe at the Program and the staff is nice. Interviewed C2, C3 and C4 stated that staff didn't bully them and didn't take the video of them. Also they did not witness S1 or other staff bully C1 or took the video of C1 or other clients. Interviews conducted do not corroborate these allegations.

Based on interviews conducted, records review and observations , there was not enough supportive evidence to concur with the reported allegations. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted, and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Nune Margaryan
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/07/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2025

LIC9099 (FAS) - (06/04)

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