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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004223
Report Date: 04/30/2025
Date Signed: 04/30/2025 09:37:58 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/17/2025 and conducted by Evaluator Perry Scott
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20250317113455
FACILITY NAME:AMBITIONS - ALBURY AVENUEFACILITY NUMBER:
306004223
ADMINISTRATOR:SMITH, STEPHNIEFACILITY TYPE:
735
ADDRESS:3836 ALBURY AVETELEPHONE:
(562) 982-4128
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY:3CENSUS: 3DATE:
04/30/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Stephanie SmithTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Staff physically abused residents.
INVESTIGATION FINDINGS:
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On 3/20/25, at 9:30am, the department conducted a complaint visit to the facility and was greeted by Stephanie Smith, Administrator. The department explained the purpose of this visit is to gather information about the complaint, gather facility files, interview staff and clients, and deliver findings for the allegations mentioned above.

The investigation consisted of the following: An initial complaint visit was completed by the department on 03/17/2025 to obtain facility files. A subsequent visit was completed by the department on 03/20/2025 and 04/17/25 to interview staff and clients. The department investigated the allegations mentioned in this complaint; and conducted interviews with staff (S1-S6) and clients (C1-C3) from 10:00am-2:00pm. The department received the following: Client Roster (Dated: 02/01/2024), Staff Roster (Dated: 10/08/2024), Pre-Placement Appraisals (Dated: 3/1/25,), ID/Emergency Information (Dated: 3/12/25, 4/1/24, 2/1/24), Client Development & Evaluation Reports (Dated: 11/29/23, 2/27/24, 3/21/24), Appraisal/Needs Service Plan (Dated: 04/01/24, 04/07/24), Incident Reports (Dated: 1/18/24, 03/22/24, 4/15/24, 5/5/24, 6/8/24,....

Report Continued On LIC9099-C Page 1 of 3
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
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 5
Control Number 11-AS-20250317113455
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: AMBITIONS - ALBURY AVENUE
FACILITY NUMBER: 306004223
VISIT DATE: 04/30/2025
NARRATIVE
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6/7/24, 8/3/24) In-Service Training (Dated: 4/22/24-1/14/25), Physicians Reports (Dated: 03/06/25, 4/2/25, 4/3/24, 4/4/24), and Personnel Records were obtained from the facility.

This complaint was referred to the California Department of Social Services Investigation Bureau for an assignment on 03/17/25. As a part of the investigation, the department obtained the following records from Integrated Life Day Program: Face Sheet and Unusual Incident/Injury Report and interviewed witness (W1) and client (C1) on 03/25/25 and 04/03/25.

Allegation- Staff physically abused residents.

It is alleged that clients have been physically abused by staff on multiple occasions while living at the facility. On 03/20/25, 03/25/25, 04/03/25, and 04/17/25 the department interviewed staff (S1-S6), witness (W1), and clients (C1-C3). 2 of 6 staff corroborated the allegation that the Staff physically abused residents, while one (1) staff refused to participate in the interview process and three (3) had no knowledge of abuse. Two staff that were interviewed stated that a member of staff pushed a client to the floor because that client was getting into their private belongings and the staff member was upset about it. Staff further state that this was the only incident that they had knowledge of in the facility, while one staff stated they witnessed the incident. The department also interviewed witness (W1) about the allegation, and they stated they had no knowledge of the incident.

The department interviewed clients (C1-C3) about the allegation and 1 of 3 clients denied the allegation, while two clients were unable to participate in the investigation due cognitive difficulties.

The department reviewed Client Development & Evaluation Reports (Dated: 11/29/23, 2/27/24, 3/21/24), Appraisal/Needs Service Plan (Dated: 04/01/24, 04/07/24), and Incident Reports (Dated: 1/2/25,1/18/24, 03/22/24, 4/2/25, 4/15/24, 5/5/24, 6/8/24, 6/7/24, 8/3/24) and observed a documented report of physical abuse against a client at the facility.



Based on interviews conducted and records reviewed, the preponderance of evidence standard has been met. Therefore, the above allegation: Staff physically abused residents, is found to be Substantiated. California Code of Regulations, Title 22, Division (6) and chapter (1) are being cited on the attached LIC 9099D. Plan of corrections due date is 05/09/2025.

Note: *Citations not cleared by the due date will have a $100 fine assessed for each citation until it is cleared. Civil penalties will continue to accrue until Proof of Corrections (POC) is cleared.

Deficiencies are issued and plans of corrections were discussed.



An exit interview was conducted with Stephanie Smith, Administrator, and a hard copy of this Complaint Investigation Report and appeal rights were provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 11-AS-20250317113455
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: AMBITIONS - ALBURY AVENUE
FACILITY NUMBER: 306004223
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/30/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/09/2025
Section Cited
CCR
80072(a)(1)(3)
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80072(a)(1)(3) Personal Rights. Except for children’s residential facilities, each client shall have specified personal rights. (1) To be accorded dignity in his/her personal relationships with staff and other persons. (3) To be free from corporal or unusual punishment, infliction of pain…The requirement is not met as evidenced by:
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The Administrator will have all staff review Title 22 80072(a)(1)(3) Personal Rights. Provide in-service training for all staff on client’s personal rights and develop a plan to ensure clients are free from abuse by staff. Submit a copy of the plan and training by POC due date of 05/09/25, to LPA’s email address perry.scott@dss.ca.gov to avoid monetary penalties. All staff must print and sign their names indicating they have taken the training.
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Based on interviews and records reviewed, the licensee failed to ensure that the facility is safe, clients are free from infliction of pain and are accorded dignity in their relationships with staff; resulting in a staff member pushing a client to the ground, which poses a potential health risk to clients 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: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
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
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/17/2025 and conducted by Evaluator Perry Scott
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20250317113455

FACILITY NAME:AMBITIONS - ALBURY AVENUEFACILITY NUMBER:
306004223
ADMINISTRATOR:SMITH, STEPHNIEFACILITY TYPE:
735
ADDRESS:3836 ALBURY AVETELEPHONE:
(562) 982-4128
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY:3CENSUS: 3DATE:
04/30/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Stephanie SmithTIME COMPLETED:
10:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff sexually abused residents.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 3/20/25, at 9:30am, the department conducted a complaint visit to the facility and was greeted by Stephanie Smith, Administrator. The department explained the purpose of this visit is to gather information about the complaint, gather facility files, interview staff and clients, and deliver findings for the allegations mentioned above.

The investigation consisted of the following: An initial complaint visit was completed by the department on 03/17/2025 to obtain facility files. A subsequent visit was completed by the department on 03/20/2025 and 04/17/25 to interview staff and clients. The department investigated the allegations mentioned in this complaint; and conducted interviews with staff (S1-S6) and clients (C1-C3) from 10:00am-2:00pm. The department received the following: Client Roster (Dated: 02/01/2024), Staff Roster (Dated: 10/08/2024), Pre-Placement Appraisals (Dated: 3/1/25,), ID/Emergency Information (Dated: 3/12/25, 4/1/24, 2/1/24), Client Development & Evaluation Reports (Dated: 11/29/23, 2/27/24, 3/21/24), Appraisal/Needs Service Plan (Dated: 04/01/24, 04/07/24), Incident Reports (Dated: 1/18/24, 03/22/24, 4/15/24, 5/5/24, 6/8/24, 6/7/24, 8/3/24) In-Service Training (Dated: 4/22/24-1/14/25), Physicians Reports (Dated: 03/06/25, 4/2/25, 4/3/24, 4/4/24), and Personnel Records were obtained from the facility.

Report Continued On LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 11-AS-20250317113455
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: AMBITIONS - ALBURY AVENUE
FACILITY NUMBER: 306004223
VISIT DATE: 04/30/2025
NARRATIVE
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This complaint was referred to the California Department of Social Services Investigation Bureau for an assignment on 03/17/25. As a part of the investigation, the department obtained the following records from Integrated Life Day Program: Face Sheet and Unusual Incident/Injury Report and interviewed witness (W1) and client (C1) on 03/25/25 and 04/03/25.

The investigation revealed the following: Allegation- Staff sexually abused residents.

It is alleged that the clients were sexually abused by staff on multiple occasions at the facility. On 03/20/25, 03/25/25, 04/03/25, and 04/17/25 the department interviewed staff (S1-S6), witness (W1), and clients (C1-C3). 5 of 6 staff denied the allegation that the Staff sexually abused residents, while one staff refused to participate in the interview process. Most of the staff denied having any knowledge about sexual abuse of any clients in their care. Staff further state that no client has ever told them or showed any sign that they may have been sexually abused by any member of the staff. The department also interviewed witness (W1) about the allegation, and they stated no client had revealed any information about any abuse to them or their staff.

The department interviewed clients (C1-C3) about the allegation and 1 of 3 clients denied the allegation, while two clients were unable to participate in the investigation due cognitive difficulties. The client that was interviewed stated that they have not been abused in any way by the staff and feels safe living in the facility.

The department reviewed Client Development & Evaluation Reports (Dated: 11/29/23, 2/27/24, 3/21/24), Appraisal/Needs Service Plan (Dated: 04/01/24, 04/07/24), and Incident Reports (Dated: 1/2/25,1/18/24, 03/22/24, 4/2/25, 4/15/24, 5/5/24, 6/8/24, 6/7/24, 8/3/24) and did not find any documented evidence of sexual abuse of any client at the facility.



Based on records reviewed and interviews conducted, there is insufficient evidence to support the allegation that the Staff sexually abused residents. Although the allegation 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 allegation is Unsubstantiated.

No citations were issued for this complaint.

An exit interview was conducted, and a hard copy of this Complaint Investigation Report was provided to Stephanie Smith, Administrator.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Perry Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5