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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005941
Report Date: NO Visit Data Available
Date Signed: 12/20/2023 12:27:15 PM

Substantiated


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
and conducted by Evaluator Kevin Saborit-Guasch
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20231026093617
FACILITY NAME:HORWITZ FAMILY HOUSEFACILITY NUMBER:
306005941
ADMINISTRATOR:MCDONALD, LISAFACILITY TYPE:
735
ADDRESS:1621 PORTOLA AVENUETELEPHONE:
(818) 782-2211
CITY:SANTA ANASTATE: CAZIP CODE:
92705
CAPACITY:6CENSUS: 6DATE:
UNANNOUNCEDTIME BEGAN:
MET WITH:Danika Lewis, administrator (by telephone)TIME COMPLETED:
ALLEGATION(S):
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Staff does not speak in an appropriate manner to clients in care
INVESTIGATION FINDINGS:
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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of delivering findings into the investigation of the allegations listed above. LPA was greeted and granted entry by facility staff after explaining the reason for the visit and listing the allegations. Facility administrator Danika Lewis was notified of the visit by phone and informed of the findings. Administrator agreed to have caregiving staff sign the report on her behalf.
An initial complaint investigation visit was conducted on October 31, 2023. LPA accompanied by care staff conducted a tour of the facility's physical plant while the six admitted clients were away. Two care staff were interviewed. LPA also requested and reviewed the training binder kept at the facility and requested additional documentation from the training portal used by the facility. The client records were also requested, obtained and reviewed.Two follow-up visits were later conducted on November 6, 2023 and December 13, 2023 with three additional staff and six additional client interviews attempted or conducted. Additional witness interviews were conducted via telephone over the course of the investigation.
CONTINUED ON FORM LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

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

DATE:
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
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
10/26/2023 and conducted by Evaluator Kevin Saborit-Guasch
PUBLIC
COMPLAINT CONTROL NUMBER: 22-AS-20231026093617

FACILITY NAME:HORWITZ FAMILY HOUSEFACILITY NUMBER:
306005941
ADMINISTRATOR:MCDONALD, LISAFACILITY TYPE:
735
ADDRESS:1621 PORTOLA AVENUETELEPHONE:
(818) 782-2211
CITY:SANTA ANASTATE: CAZIP CODE:
92705
CAPACITY:6CENSUS: 6DATE:
12/20/2023
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Danika Lewis, Administrator (via phone)TIME COMPLETED:
12:40 PM
ALLEGATION(S):
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Licensee does not ensure staff are properly trained to care for clients

Facility physical plant is not kept in good repair
INVESTIGATION FINDINGS:
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On this day, Licensing Program Analyst (LPA) Kevin Saborit-Guasch made an unannounced visit to the facility for the purpose of delivering findings into the investigation of the allegations listed above. LPA was greeted and granted entry by facility staff after explaining the reason for the visit and listing the allegations. Facility administrator Danika Lewis was notified of the visit by phone and informed of the findings. Administrator agreed to have caregiving staff sign the report on her behalf.
An initial complaint investigation visit was conducted on October 31, 2023. LPA accompanied by care staff conducted a tour of the facility's physical plant while the six admitted clients were away. Two care staff were interviewed. LPA also requested and reviewed the training binder kept at the facility and requested additional documentation from the training portal used by the facility. The client records were also requested, obtained and reviewed.Two follow-up visits were later conducted on November 6, 2023 and December 13, 2023 with three additional staff and six additional client interviews attempted or conducted. Additional witness interviews were conducted via telephone over the course of the investigation.
CONTINUED ON FORM LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 22-AS-20231026093617
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: HORWITZ FAMILY HOUSE
FACILITY NUMBER: 306005941
VISIT DATE: 12/20/2023
NARRATIVE
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CONTINUED FROM FORM LIC9099-A
Regarding the allegation that Licensee does not ensure staff are properly trained to care for clients, the following has been concluded: LPA interviewed a total of five different staff members, all of whom confirmed that they had received both general onboarding training as well as specific training dedicated to the handling of potential behavior episodes in clients and adequate staff responses. Staff members interviewed stated that they felt adequately trained for the requirements of their respective positions. Additionally, the facility now uses a training portal provided by Relias to follow up on staff training and ensure compliance in that regard. However, training records in place prior to the implementation of Relias appeared incomplete and could not fully corroborate the adequacy of training at that time. As a result the allegation is found to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred.

Regarding the allegation that Facility physical plant is not kept in good repair, the following has been concluded: Previously employed staff complained to facility management that some of the appliances were dirty. Currently employed staff however did not corroborate the statements. Multiple inspections of the physical plant were also unable to corroborate the allegation. The washing machine and drier were observed to be operational and clean during the course of the investigation. The allegation is thus found to be Unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred.

An exit interview was conducted and a copy of this report was provided to a facility representative.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 22-AS-20231026093617
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: HORWITZ FAMILY HOUSE
FACILITY NUMBER: 306005941
VISIT DATE: 12/20/2023
NARRATIVE
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CONTINUED FROM LIC9099
Regarding the allegation that Staff does not speak in an appropriate manner to clients in care, the following has been concluded: At the time of the initial complaint investigation visit, it was determined that staff member S1, house manager for the facility had been placed on administrative leave due to an ongoing investigation led by facility management as well as Regional Center of Orange County Quality Assurance staff after concerns of inappropriate interactions with facility clients were made. Both investigations concluded that the actions had been evidenced. Two client interviews conducted by LPA Saborit-Guasch on November 6, 2023 also corroborated the concerns of ongoing inappropriate verbal and/or physical interactions for which S1 was responsible. By the time the final follow-up visit was conducted, it was determined that the licensee had voluntarily ended S1's employment based on the evidence gathered.

As a result, the allegation is found to be Substantiated, meaning that the preponderance of evidence threshold has been met. A type A citation is issued on an attached form LIC9099-D and is cleared based on the corrective actions taken by the licensee and evidenced during the investigation.

An exit interview was conducted and a copy of this report along with appeal rights were provided to a facility representative.
SUPERVISORS NAME: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 22-AS-20231026093617
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: HORWITZ FAMILY HOUSE
FACILITY NUMBER: 306005941
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/21/2023
Section Cited
CCR
80072(a)(1)
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The California Code of Regulations states that "(a) (...) 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." This requirement was not met as evidenced
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Licensee terminated S1's employment voluntarily and ensured that all current staff members were adequately trained to the requirements of their respective positions. The present deficiency cited is thus cleared during the visit.
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Based on interviews conducted with witnesses, staff members and clients in care at the facility, staff member S1 was responsible for inappropriate interactions with clients on multiple occasions. This constitute an immediate risk to the health, safety and personal rights of 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: Sheila Santos
LICENSING EVALUATOR NAME: Kevin Saborit-Guasch
LICENSING EVALUATOR SIGNATURE:

DATE: 12/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5