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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306006074
Report Date: 11/18/2025
Date Signed: 11/18/2025 03:52:08 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
10/23/2024 and conducted by Evaluator RoseMarie Ruppert
COMPLAINT CONTROL NUMBER: 22-AS-20241023164211
FACILITY NAME:SUCCESSFUL PEOPLE LLC #5FACILITY NUMBER:
306006074
ADMINISTRATOR:SNODDY, FRANCESFACILITY TYPE:
735
ADDRESS:1774 W CHALET AVETELEPHONE:
(310) 902-4893
CITY:ANAHEIMSTATE: CAZIP CODE:
92804
CAPACITY:4CENSUS: 2DATE:
11/18/2025
UNANNOUNCEDTIME BEGAN:
03:21 PM
MET WITH:Feyifoluwa "Fey" Ojo, Direct Support ProfessionalTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Facility does not have sufficient staffing to meet the clients' needs.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Rose Ruppert made an unannounced visit to deliver findings for a complaint received in the Regional Office on October 23. 2024. LPA was greeted and granted entry by staff and met with Fey Ojo, Direct Support Professional. LPA explained the purpose of the visit.

It is alleged that the Facility does not have sufficient staffing to meet the clients' needs. The Department conducted a visit on October 30, 2024 and interviewed one client who could not confirm, nor deny, the allegation. The Department also interviewed two of two witnesses who could not confirm, nor deny allegation on October 30, 2024.

The Department interviewed four of four staff members. Two of the four staff members did not work at the facility in October 2024 and could not confirm, nor deny allegation. Two of the four staff members confirmed the allegation. One of the clients required two staff members and the Department observed only one staff.
(Continued on LIC 9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
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 3
Control Number 22-AS-20241023164211
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: SUCCESSFUL PEOPLE LLC #5
FACILITY NUMBER: 306006074
VISIT DATE: 11/18/2025
NARRATIVE
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(Continued from LIC 9099)

LPA reviewed four of four client files, which included Individual Program Plans (IPPs) and Individual Behavior Support Plans (IBSP). Per IPP and IBSP, Client #3 (C3) required two staff members. In October 2024, there was a census of four clients; which would require two to three staff members to meet the clients' needs. The Department observed one staff member present.

Based on the Department's observations, file review and interviews, the preponderance of evidence has been met. Therefore the allegation that the Facility does not have sufficient staffing to meet the clients' needs is Substantiated. A deficiency will be cited per Title 22, California Code of Regulations.

An exit interview was conducted with Fey Ojo, Direct Support Professional, and a copy of this report, LIC 811, LIC 9099-D and Appeal Rights were provided to the facility.
SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 22-AS-20241023164211
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: SUCCESSFUL PEOPLE LLC #5
FACILITY NUMBER: 306006074
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/18/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/19/2025
Section Cited
CCR
85065.5(a)(1)
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85065.5 Day Staff-Client Ratio. (a) Whenever a client who relies upon others to perform all activities of daily living is present, the following minimum staffing requirements shall be met:(1) For Regional Center clients, staffing shall be maintained as specified by the Regional Center but no less than one
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Administrator (AD) will provide a signed Memo of Understanding regarding staffing requirement regulation 85065 and 85065.5. AD will email documentation to LPA by end of business 11/19/2025.
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direct care staff to three such clients. This requirement was not met as evidenced by: Based on Department observations and interviews there was one staff member to four clients. This poses an immediate health and safety risk to 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: Alisa Ortiz
LICENSING EVALUATOR NAME: RoseMarie Ruppert
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3