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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603289
Report Date: 02/27/2026
Date Signed: 02/27/2026 04:51:15 PM

Substantiated


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
02/18/2026 and conducted by Evaluator Nune Margaryan
COMPLAINT CONTROL NUMBER: 28-AS-20260218160454
FACILITY NAME:KAISER BEHAVIORAL CENTER WEST COVINAFACILITY NUMBER:
198603289
ADMINISTRATOR:JANET DE LUNAFACILITY TYPE:
775
ADDRESS:1532 AMAR ROAD STE BTELEPHONE:
(626) 945-0790
CITY:WEST COVINASTATE: CAZIP CODE:
91790
CAPACITY:75CENSUS: 44DATE:
02/27/2026
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Ka Lee -Program Manager (Interim)TIME COMPLETED:
10:45 AM
ALLEGATION(S):
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Staff restrained a client in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Nune Margaryan conducted a subsequent unannounced complaint visit to deliver finding to the above-mentioned allegation. LPA met with Interim Program Manager and explained the reason for visit. .

The investigation consisted of the following: On 02/23/26 LPA toured the common areas, obtained copies of Staff & Clients Rosters, interviewed District Manager, Staff 1 to Staff 4 (S1 to S4), Client 2, Client 3 (C2, C3). LPA was not able to interview Client 1(C1) due to being non-verbal. LPA obtained the copies of relevant documents.

Continue 9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026
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 5
Control Number 28-AS-20260218160454
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: 02/27/2026
NARRATIVE
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During this investigation, the LPA interviewed the District Manager, Staff S1 through S4, and Clients C2 and C3. Interviews conducted with the Administrator and staff revealed that on 02/12/26, former staff member S5 improperly restrained Client C1. The District Manager stated that on 02/19/26, they were informed that C1 had been improperly restrained by S5. Based on agency protocol, the decision was made to place S5 on Administrative Leave pending the outcome of the investigation. Staff S1 reported that on 02/12/26, S5 inappropriately restrained C1 during a behavioral episode. According to S1, the behavior began when S5 attempted to retrieve a water bottle from C1, which C1 wanted to keep. C1 began hitting, and S1 attempted to block the strikes. At that time, S5 pushed C1 against the wall, then immediately forced C1 to the floor and sat on top of him. S1 stated that no other staff were physically involved in the incident. S1 attempted to assist, but S5 stated assistance was not needed. After some time, C1 calmed down, and S1 helped him sit up. No injuries were observed on C1. Staff S2 stated they were out of the room at the time of the incident. Upon returning, S2 observed C1 exhibiting behaviors. S2 reported that S5 instructed them to remove the other participants from the room. Although S2 did not personally witness the restraint, they were informed by S1 (make sure by whom S1 was informed) that C1 had allegedly been slammed to the floor and that S5 sat on C1’s back. Staff S3 stated they overheard employees discussing the incident and heard that S5 did not use proper CPI techniques, allegedly slammed C1 to the floor, and sat on C1’s back. Staff S4 stated that at the time of the incident, they were in a room across from where the incident occurred. S4 reported hearing raised voices and observed S5 standing in the doorway. S4 asked if assistance was needed, and S5 responded that they would handle the situation alone. The District Manager confirmed that the technique reportedly used by S5 is not permitted under CPI training guidelines. The District Manager further stated that staff have since been retrained regarding appropriate behavioral intervention techniques and proper approaches when working with clients. S5 has since resigned and is no longer employed at the facility. Clients C2 and C3 stated that they feel comfortable attending the Day Program, that staff treat them well, and that no one has restrained them. They reported no knowledge of the incident involving S5 and C1. The LPA attempted to interview C1; however, C1 is non-verbal and did not respond to the questions asked.

Based on interviews conducted and information obtained, the preponderance of evidence standard has been met, therefore, the above allegation is found to be Substantiated.

Exit interview conducted with Ka Lee. A copy of this report and Appeal Rights were provided.

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
02/18/2026 and conducted by Evaluator Nune Margaryan
COMPLAINT CONTROL NUMBER: 28-AS-20260218160454

FACILITY NAME:KAISER BEHAVIORAL CENTER WEST COVINAFACILITY NUMBER:
198603289
ADMINISTRATOR:JANET DE LUNAFACILITY TYPE:
775
ADDRESS:1532 AMAR ROAD STE BTELEPHONE:
(626) 945-0790
CITY:WEST COVINASTATE: CAZIP CODE:
91790
CAPACITY:75CENSUS: 44DATE:
02/27/2026
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Ka Lee -Program Manager (Interim)TIME COMPLETED:
10:45 AM
ALLEGATION(S):
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Staff did not ensure CCL licensing poster is posted at the facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Nune Margaryan conducted a subsequent unannounced complaint visit to deliver finding to the above-mentioned allegation. LPA met with Interim Program Manager and explained the reason for visit. .

The investigation consisted of the following: On 03/23/26 LPA toured the common areas, obtained copies of Staff & Clients Rosters, interviewed District Manager, Staff 1 to Staff 4 (S1 to S4), Client 2, Client 3 (C2, C3). LPA was not able to interview Client 1(C1) due to being non-verbal. LPA obtained the copies of relevant documents.

Continue 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 28-AS-20260218160454
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: 02/27/2026
NARRATIVE
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It was alleged that staff did not ensure the Community Care Licensing (CCL) poster was posted at the facility and that the Program Director removed the Licensing poster from the walls after staff expressed concerns.

During the investigation, the Licensing Program Analyst (LPA) toured the facility’s common areas and observed required postings. The Complaint Hotline for the Department of Social Services (“LET US KNOW” poster) was observed posted at the entrance of the facility and in the administration office area. The District Manager stated that all required postings, including the “LET US KNOW” poster, are displayed at the entrance and in the hallway between the offices. Staff interviews revealed the following: S1 stated they did not witness or hear of anyone removing the Licensing poster or reporting information. S2 stated they did not observe the Program Director or any staff remove licensing documents or posters and did not recall any licensing related postings missing since beginning employment. S3 and S4 indicated that all required posters are displayed at the front of the facility and stated that necessary contact information is also available online. Client interviews revealed: C2 and C3 stated they did not have complaints and were unable to answer questions regarding the Licensing poster.

Based on observations conducted during the facility tour and interviews with staff and clients, there was insufficient evidence to support the allegation, therefore the above allegation is Unsubstantiated.

Exit interview conducted with Ka Lee. A copy of this report was provided.

SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 28-AS-20260218160454
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/27/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/27/2026
Section Cited
CCR
82102(a)(8)
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Emergency Intervention Prohibitions.(a) The following emergency interventions shall not be used on a client:(8) Any manual restraint technique in which a staff member places pressure on a client's back or places his or her body weight against the client's torso or back.


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Licensee shall ensure staff properly to handle clients' behaviors and provide refresher training for the staff. Proof of training will be email to LPA.
S5 has resigned and is no longer working at the facility.
POC is cleared.
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This requirement is not met as evidenced by: Based on interviews conducted and information obtained S5 improperly restrained C1, which poses an immediate health, safety and personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Wei Siew Ho
LICENSING EVALUATOR NAME: Nune Margaryan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/27/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5