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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004436
Report Date: 05/24/2024
Date Signed: 05/24/2024 04:16:57 PM

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
11/06/2023 and conducted by Evaluator Ernand Dabuet
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20231106093830
FACILITY NAME:STONYBROOK RESIDENTAL CARE IIFACILITY NUMBER:
306004436
ADMINISTRATOR:CLIFFORD T VALMEOFACILITY TYPE:
735
ADDRESS:2301 PEPPERWOOD AVENUETELEPHONE:
(562) 498-4413
CITY:LONG BEACHSTATE: CAZIP CODE:
90808
CAPACITY:4CENSUS: 4DATE:
05/24/2024
UNANNOUNCEDTIME BEGAN:
10:43 AM
MET WITH:Cesar Eguilos House ManagerTIME COMPLETED:
11:47 AM
ALLEGATION(S):
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Facility staff sexually assaulted resident.
INVESTIGATION FINDINGS:
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On 05/24/24, Licensing Program Analyst (LPA) Ernand Dabuet made an unannounced visit to this facility and was greeted by House Manager and Direct Support Provider (S#2: Cesar Esguilos). Esquilos contacted administrator #1 (A#1) Brandon Penalosa who could not be at the faiclity. LPA explained the purpose for today’s visit is to conduct a subsequent visit and deliver the findings pertaining to the above-mentioned allegation. LPA Dabuet read the complaint report to (A#1) by telephone and authorized (S#2) to sign the complaint report.

A 24-hour visit was conducted by Licensing Program Analyst (LPA) Jose Calderon on 11/06/23 for health & safety purposes and to ensure the wellbeing of clients in care. The investigation consisted of the following: a tour of the physical plant and all clients were in the facility. During today’s visit, LPA reviewed the following documents: Client Roster; Personnel Report Staff Roster; Client #1 (C#1)’s Appraisal/Needs and Service Plan LIC 625 (dated: 01/10/24); Long Beach Police Department Incident Report DR 23054709 (dated: 11/02/23); (Evaluation Report continues LIC 9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2024
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 4
Control Number 11-AS-20231106093830
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: STONYBROOK RESIDENTAL CARE II
FACILITY NUMBER: 306004436
VISIT DATE: 05/24/2024
NARRATIVE
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and Long Beach Sexual Assault Examination Response Team (SART) (dated: 11/02/23).

The complaint was referred to the California Department of Social Services Investigations Branch and was assigned to Investigator (Juan Lozano) which included a review of (C#1)’s service records, Appraisal/Needs and Service Plan LIC 625 (dated: 01/10/24); Long Beach Police Department Incident Report DR 23054709 (dated: 11/02/23); AND Long Beach Sexual Assault Examination Response Team (SART) (dated: 11/02/23; interviews with client #1 (C#1), administrator #1 (A#1); staff #1-#2 (S#1-S#2), and witnesses #1-#3; local law enforcement (W#1); (S#1) consort (W#2); and Harbor Regional Center staff (W#3).

INVESTIGATION REVEALED THE FOLLOWING:

Allegation: Facility staff sexually assaulted resident.

This investigation revealed that Client #1 (C#1) was sexually assaulted by staff #1 (S#1). An investigation conducted by Long Beach Police Detective witness #1 (W#1), (S#1) confessed to having sexual interaction with (C#1).

On 12/15/23 at 3:22 pm, (CDSS) Investigation Branch Investigator Juan Lozano interviewed the Long Beach Police Detective witness #1 (W#1). The interview with (W#1) revealed, (S#1) voluntarily provided a statement of having sex with (C#1) on 11/03/23 at 02:55 pm. According to the Long Beach Police Department Incident Report DR 23054709 (dated: 11/02/23), (S#1) agreed to provide explicit detailed statements with (W#1) of the sexual contact with (C#1). (S#1) stated (S#1) was the only overnight staff member on shift at Stonybrook Residential Home II on 11/01/23, when (S#1) claimed the sexual assault that lasted approximately several minutes with (C#1).

On 01/08/24, at 01:00 pm, (CDSS) Investigation Branch Investigator Juan Lozano interviewed client #1 (C#1). (C#1) spontaneously stated, (S#1) sexually assaulted (C#1). (C#1) communicated that (S#1) prohibited (C#1) to tell anyone about the incident.

(Evaluation Report continues LIC 9099-C)

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 11-AS-20231106093830
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: STONYBROOK RESIDENTAL CARE II
FACILITY NUMBER: 306004436
VISIT DATE: 05/24/2024
NARRATIVE
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On 01/08/24, at 01:25 pm, (CDSS) Investigation Branch Investigator Juan Lozano interviewed, administrator #1 (A#1). (A#1) disclosed that (S#1) was the only staff working the night of 11/01/23 and was aware of the allegation that (C#1) made against (S#1). (A#1) added to have been blind sided by the incident and never suspected that (S#1) would such act to any of the clients.

Per medical records for (C#1) from the Long Beach Sexual Assault Response Team (SART), (C#1) was examined on 11/02/23, and revealed (C#1) to be positive for three (3) soft tissue injuries that were described as lacerations to Midline Posterior Fourchette.

On November 8, 2023, (S#3) was arrested and booked by (W#1) Long Beach Police Department. (S#1) was charged with 261 (A)(1) Penal Code (PC) rape: Victim (C#1) incapable of giving consent, 286(A) PC Sodomy, and 288 (C) (2) PC Lewd and Lascivious Acts with a dependent adult by a caretaker.

Based on the information collected, an inspection of the facility, observation, interviews conducted, and an analysis of records reviewed, the preponderance of evidence standard has been met; therefore, the allegation of PHYSICAL ABUSE: “Facility staff sexually assaulted resident”, is found to be SUBSTANTIATED.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), the following deficiency has been observed and a citation issued (ref. LIC 9099D).

An exit interview has been conducted and a copy of the Complaint Report and Appeal Rights were provided to the House Manager and Direct Support Provider (Cesar Equilos).

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 11-AS-20231106093830
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: STONYBROOK RESIDENTAL CARE II
FACILITY NUMBER: 306004436
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/24/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/25/2024
Section Cited
CCR
80072(a)(1-3)
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80072(a) (1-3) Personal Rights (a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following: (1) To be accorded dignity in his/her personal relationships with staff and other persons. (2) To be accorded safe, healthful and comfortable accommodations…(3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of punitive nature, including but not limit to…
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Licensee/Administrator shall ensure a training for all staff on Title 22, Section 80072 “Personal Rights” is conducted and send the sign in sheets and training materials to the CCLD by the Plan of Correction (POC) due date by 05/25/24 to the attention of: ernand.dabuet@dss.ca.gov
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This requirement is not met as evidenced by:
Staff failed to supervise Client #1 (C#1) resulting in the client being sexually assaulted by staff #1 (S#1). An investigation provided evidence of lacerations to (C#1) and an admission of quilt from (S#1). This violation poses an immediate health, safety, or personal right risk to persons 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: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 4