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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005918
Report Date: 05/20/2025
Date Signed: 05/20/2025 04:30:27 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, 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
03/07/2025 and conducted by Evaluator Sean Haddad
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250307102308
FACILITY NAME:LI'L HOUSE ON FARRINGTON, THEFACILITY NUMBER:
306005918
ADMINISTRATOR:JABONERO, JEREMIASFACILITY TYPE:
735
ADDRESS:1241 FARRINGTON DR.TELEPHONE:
(714) 975-3025
CITY:LA HABRASTATE: CAZIP CODE:
90631
CAPACITY:4CENSUS: 4DATE:
05/20/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jeremias JaboneroTIME COMPLETED:
04:45 PM
ALLEGATION(S):
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Facility staff did not allow resident to use the bathroom
Lack of supervision resulted in resident eloping
INVESTIGATION FINDINGS:
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This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of delivering findings for the investigation into the above identified complaint allegations. LPA met with Administrator (AD) Jeremias Jabonero and explained the reason for today’s inspection.

The investigation into the allegations that facility staff did not allow resident to use the bathroom and lack of supervision resulted in resident eloping revealed the following: During the course of the investigation, LPA inspected the facility, interviewed AD, clients, and staff, and obtained and reviewed copies of the client roster, staff roster, an audio recording, and a facility incident report.

CONTINUED
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
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 22-AS-20250307102308
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: LI'L HOUSE ON FARRINGTON, THE
FACILITY NUMBER: 306005918
VISIT DATE: 05/20/2025
NARRATIVE
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Regarding the allegation that facility staff did not allow resident to use the bathroom: it was alleged that Client #1 (C1) asked staff to go to the bathroom and staff denied C1’s request, told C1 they did not need to go, and told C1 to go back to their room. LPA inspected the facility, conducted health and safety checks on all four clients, and observed no health and safety issues. LPA reviewed an audio recording in which C1 asks to use the bathroom and facility staff deny C1’s request and tell C1 to go back to their room. LPA interviewed AD and two staff who denied the allegation, stating that C1 had already used the bathroom, C1 had urinated themselves in the living room, facility staff were cleaning up the living room and told C1 to wait in their room, and as soon as the staff was done, they took C1 to the bathroom where C1 did not need to use the restroom. LPA interviewed four clients and did not obtain additional information corroborating the allegation. Although C1 was later provided assistance in using the bathroom, the information corroborated that facility staff did deny C1’s request to use the bathroom.

Regarding the allegation that lack of supervision resulted in resident eloping: it was alleged that C1 eloped from the facility, was gone all day, and was found one mile away from the facility. LPA inspected the facility, conducted health and safety checks on all four clients, and observed no health and safety issues. LPA interviewed AD who admitted the allegation, stating that during this incident there were two staff present at the facility attending to various tasks, C1 left the facility without their notice, when staff noticed C1 missing the police were called and a search for C1 was initiated, and C1 was found by the police at a local grocery store. LPA reviewed a facility incident report stating that on April 5, 2024, around 10:00AM, staff noticed that C1 was not present at the facility, the police were called and a search initiated, C1 was found by police at about 10:50AM at a grocery store about a quarter of a mile away, and C1 did not need any medical treatment. LPA interviewed four clients and did not obtain any additional information corroborating the allegation. The information obtained corroborated the allegation.

During the course of the investigation, the Department obtained sufficient evidence to substantiate the allegations mentioned above. The preponderance of evidence standard has been met; therefore, the above allegations are Substantiated. See LIC9099D for cited deficiencies per Title 22 Division 6 of the California Code of Regulations. An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 22-AS-20250307102308
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: LI'L HOUSE ON FARRINGTON, THE
FACILITY NUMBER: 306005918
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/21/2025
Section Cited
CCR
80078(a)
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80078 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the client's needs. This requirement was not met as evidenced by:
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Licensee stated they have since installed exit alarms and during today’s inspection LPA confirmed. Licensee stated they will conduct staff training on preventing elopements and submit proof to LPA by POC due date.
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Based on documents and admission, the licensee did not ensure C1 received care and supervision necessary to meet their needs when they eloped from the facility, which poses an immediate safety risk to persons in care.
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Type B
06/17/2025
Section Cited
CCR
85077(a)
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85077 Personal Services (a) Licensees shall provide necessary personal assistance and care, as indicated in the needs and services plan, with activities of daily living... This requirement was not met as evidenced by:
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Licensee stated they will create a toileting protocol for C1, train staff on the protocol, and submit proof to LPA by POC due date.
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Based on documents and interviews, the licensee did not ensure C1 received assistance with toileting needs when staff made C1 wait for assistance, which poses a potential personal rights 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: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC9099 (FAS) - (06/04)
Page: 3 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, 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
03/07/2025 and conducted by Evaluator Sean Haddad
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20250307102308

FACILITY NAME:LI'L HOUSE ON FARRINGTON, THEFACILITY NUMBER:
306005918
ADMINISTRATOR:JABONERO, JEREMIASFACILITY TYPE:
735
ADDRESS:1241 FARRINGTON DR.TELEPHONE:
(714) 975-3025
CITY:LA HABRASTATE: CAZIP CODE:
90631
CAPACITY:4CENSUS: 4DATE:
05/20/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Jeremias JaboneroTIME COMPLETED:
04:45 PM
ALLEGATION(S):
1
2
3
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5
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9
Lack of supervision resulted in physical altercation between residents
INVESTIGATION FINDINGS:
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This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of delivering findings for the investigation into the above identified complaint allegation. LPA met with Administrator (AD) Jeremias Jabonero and explained the reason for today’s inspection.

The investigation into the allegation that lack of supervision resulted in physical altercation between residents revealed the following: During the course of the investigation, LPA inspected the facility, interviewed AD, clients, and staff, and obtained and reviewed copies of the client roster, staff roster, an audio recording, and Client #1’s (C1) Individual Program Plan.

CONTINUED
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
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 22-AS-20250307102308
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: LI'L HOUSE ON FARRINGTON, THE
FACILITY NUMBER: 306005918
VISIT DATE: 05/20/2025
NARRATIVE
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It was alleged that C1 sustained a bruise to their right eye which was caused by another client hitting C1. LPA inspected the facility, conducted health and safety checks on all four clients, and observed no injuries on any of the clients. LPA reviewed an audio recording of the incident, during which a staff redirects a client for hitting someone, but it is not possible to determine whether the person hit was a client or staff. LPA interviewed AD who denied the allegation, stating that the altercation alleged was between another client and a staff during which the client hit the staff and was then redirected. Per AD, any bruises on C1 are caused by C1 hitting themselves, C1 has a documented history of self-injurious behavior, and staff redirect C1 when they engage in this behavior. Per C1’s Individual Program Plan, C1 has a history of hitting themselves in the head when frustrated. LPA observed C1 hitting themselves and being redirected by staff during the inspection. LPA interviewed the two staff who were witnesses to the alleged altercation, both of whom confirmed that no altercation occurred between clients. LPA interviewed four clients and did not obtain information corroborating the allegation. The information obtained did not corroborate the allegation.

Based on the information gathered during the investigation and review of all documents obtained, the Department is unable to ascertain if the above allegation occurred as reported. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed Unsubstantiated. An exit interview was conducted and a copy of this report was discussed with and provided to facility representative.
SUPERVISORS NAME: Armando J Lucero
LICENSING EVALUATOR NAME: Sean Haddad
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5