306005159-1-15-2026-22-AS-AORZ-DQLV22-20260123150227

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005159
Report Date: 01/15/2026
Date Signed: 01/15/2026 09:54:01 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/05/2025 and conducted by Evaluator Hanna Gough

COMPLAINT CONTROL NUMBER: 22-AS-20251105135854

FACILITY NAME:	EMERYWOOD BOARD & CARE HOME		FACILITY NUMBER:	306005159
ADMINISTRATOR:	HERNANDEZ, MARISA C		FACILITY TYPE:	735
ADDRESS:	8522 EMERYWOOD DRIVE		TELEPHONE:	(714) 290-3809
CITY:	BUENA PARK	STATE: CA	ZIP CODE:	90621
CAPACITY:	6	CENSUS: 6	DATE:	01/15/2026
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Chris Moore		TIME COMPLETED:	10:10 AM

ALLEGATION(S):

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Client sexually assaulted another client due to lack of supervision

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Hanna Gough made an unannounced visit to the facility to investigate the above mentioned complaint allegation. LPA was greeted and granted entry by staff. LPA met with House Manager (HM) Chris Moore and discussed the purpose of the visit. HM contacted Administrator(AD) Marisa Hernandez and AD was available by phone.

The investigation into the allegation of client sexually assaulted another client due to lack of supervision revealed the following: It was alleged that Client #1 (C1) entered a bedroom where Client #2(C2) and Client #3(C3) were visiting and C1 then exposed their penis to C2 and C3. Then it was alleged that C1 exposed their penis and then tried touching C2 in front of C3. LPA observed a physicians report for C1 dating April 4, 2023, stating that C1 is able to follow instructions, able to communicate and does not need constant medical supervision. LPA observed an Individual Program Plan (IPP) for C1 dated January 30, 2025, that does not indicate any extra supervision is needed due to sexually inappropriate behaviors.
Continue on LIC-9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Hanna Gough
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026

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 22-AS-20251105135854

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: EMERYWOOD BOARD & CARE HOME	FACILITY NUMBER: 306005159
	VISIT DATE: 01/15/2026

NARRATIVE

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LPA reviewed a facility annual review dated January 30, 2025, stating that C1 gets along with peers and staff at the facility and has not displayed any behavioral outbursts with peers or staff. C1s IPP and facility annual review do not mention a history of sexual assault or behaviors.

During interviews with C1 it was revealed that C1 walked into the bedroom that C2 and C3 were in and exposed their penis to C2 and C3. C1 informed LPA that C2 told them to stop and they pulled up their pants and walked away. C1 informed LPA that they did not say anything or touch C2 or C3. C1 informed LPA that they realized it was wrong and will not do it again. C1 informed LPA that facility staff spoke with them regarding this incident.

LPA reviewed a physicians report for C2 dated April 8, 2023, stating that they are able to follow directions and communicate their needs, but do not need constant medical supervision. LPA reviewed an IPP addendum for C2 dated September 10, 2024, stating that C2 has had disruptive behaviors such as making false statements. LPA reviewed an IPP for C2 dated December 12, 2024, stating that C2 was issued a formal written notice by the facility due to their behaviors. LPA observed the formal client warning letter dated September 10, 2024, stating that C2 has a history of making false and exaggerated statements.

During interviews with C2 it was revealed to LPA that C1 exposed their penis in front of C2 and C3 and that C1 touched C2. LPA interviewed C2 a second time and it was revealed that C1 did not actually touch C2 at the time of the incident. C2 informed LPA that they spoke with facility staff about the incident that occurred.

LPA was unable to interview C3 due to being at work when LPA visited the facility and not answering their phone when LPA tried to contact them.

During interviews with staff it was revealed to LPA by two of two staff that C2 has a history of false statements and exaggerating incidents that occur. Two of two staff informed LPA that they were initially informed about the incident and was told that C1 touched C2 after exposing themselves and then later informed that C1 did not touch C2 by C1. Two of two staff informed LPA that C1 does not have a history of exposing themselves or a history of sexual assault or sexual behaviors. Two of two staff informed LPA that clients are now to gather in communal spaces instead of their private bedrooms for better supervision.

Continue on LIC9099C

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Hanna Gough
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026

LIC9099 (FAS) - (06/04)

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Control Number 22-AS-20251105135854

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: EMERYWOOD BOARD & CARE HOME	FACILITY NUMBER: 306005159
	VISIT DATE: 01/15/2026

NARRATIVE

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During interviews with C2s responsible party (RP) it was revealed to LPA that C2 has a history of false statements and exaggeration of incidents. RP informed LPA that they are aware of the incident that took place with C1 and believed the exposure happened, but that is all based on conversations regarding the incident with C2.

During interviews with Witness #1(W1) it was revealed that they have been overseeing C1 for a few years and since they have known C1, C1 has not had a history of sexual behaviors for facility staff to look out for.

Based on interviews conducted, information gathered and review of documents the facility allegation of Client sexually assaulted another client due to lack of supervision has been deemed UNSUBSTANTIATED.

Although the allegation occurred, it did not occur due to a lack of supervision. The facility took immediate action and started to investigate the allegation internally. Facility staff met with W1, C2 and their responsible party. LPA observed meeting notes dated November 3, 2025, discussing the allegation and the incident that occurred between C1 and C2. Two of two staff informed LPA that clients are asked to congregate in communal spaces rather than private bedrooms for supervision purposes. Five of six clients informed LPA that they spoke with the Administrator regarding the incident that took place.

An exit interview was conducted and a copy of this report was left at the facility.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Hanna Gough
LICENSING EVALUATOR SIGNATURE:	DATE: 01/15/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2026

LIC9099 (FAS) - (06/04)

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