306005159-8-15-2025-22-AS-APAO-DKXTWX-20250827150614

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005159
Report Date: 08/15/2025
Date Signed: 08/15/2025 11:51:01 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/13/2025 and conducted by Evaluator Claudia Gutierrez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20250813094015

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:	08/15/2025
		UNANNOUNCED	TIME BEGAN:	07:45 AM
MET WITH:	Christian Moore		TIME COMPLETED:	12:10 PM

ALLEGATION(S):

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Facility violated clients' personal rights
Lack of care and supervision for clients
Clients do not have access to their cash resources

INVESTIGATION FINDINGS:

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An unannounced Complaint Investigation was conducted on this day by Licensing Program Analyst (LPA) Claudia Gutierrez regarding the allegations mentioned above. LPA met with Staff Christian Moore and explained the purpose of the inspection.

Regarding the allegations, facility violated clients’ personal rights and lack of care and supervision for clients, the following was revealed: It is alleged clients’ rights are being violated as clients are not allowed at the facility between 9:00 a.m. and 3:00 p.m. due to insufficient staffing. Interviews were conducted with two facility staff and four clients. Two of two staff interviewed denied clients are being made to leave the facility due to insufficient staffing. Per Staff 1 (S1), clients are allowed to be present at the facility at all times and denied clients are forced to leave the facility at any time. S1 provided LPA with a text message they sent Administrator (AD) Marisa Hernandez from their cell phone. The text message is from Wednesday, March 13, 2025, at 9:45 a.m. and outlines the clients’ schedule for the day and indicates Client 2 (C2) would be staying home at the facility for the day. (Cont. LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2025

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 22-AS-20250813094015

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: EMERYWOOD BOARD & CARE HOME	FACILITY NUMBER: 306005159
	VISIT DATE: 08/15/2025

NARRATIVE

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During their interview, Administrator (AD) Marisa Hernandez denied clients are forced to leave the facility at any time. Per AD, facility clients have day program and active work and social lives, and are typically not present between the hours of 9:00 a.m. and 2:00 p.m. Per AD, for this reason staff is not scheduled during these hours, however AD and S1 are on-call in the event a client stays home at the facility for the day or returns to the facility prior to 2:00 p.m. During their interview, one of four clients confirmed the allegation and stated clients are not allowed to be present at the facility between 9:00 a.m. and 2:00 p.m. Two of four clients denied the allegation and stated they are not typically present at the facility between the hours of 9:00 a.m. and 2:00 p.m. due to work and leisure activities of their choosing. One of four clients was unable to confirm or deny allegation and stated they were unsure if clients were not allowed at the facility during certain hours of the day.

Interviews were conducted with two facility staff and four clients regarding allegation, clients do not have access to their cash resources. Two of two staff interviewed denied the allegation and stated all clients have access to their cash resources. Four of four clients interviewed stated their cash resources are managed by staff and available upon request. Clients denied staff ever withholding their cash resources from them or having any knowledge of staff withholding cash resources from any other client.

Due to conflicting information received during interviews conducted, LPA is unable to determine if facility violated clients' personal rights, if there is a lack of care and supervision for clients, or if clients do not have access to their cash resources. Although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore at this time the above allegations are unsubstantiated.

An exit interview was conducted and copy of this report was provided at the end of the inspection.

SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Claudia Gutierrez
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2025

LIC9099 (FAS) - (06/04)

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