331880610-2-7-2026-18-AS-LHIS-DR5PPD-20260209102919

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 331880610
Report Date: 02/07/2026
Date Signed: 02/07/2026 02:34:08 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/28/2024 and conducted by Evaluator Alberto Lopez

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20240528084842

FACILITY NAME:	BENSON HOUSE INC #16		FACILITY NUMBER:	331880610
ADMINISTRATOR:	ADEBAYO A. FIJABI		FACILITY TYPE:	737
ADDRESS:	222 CAMINO LOS BANOS		TELEPHONE:	(951) 487-0350
CITY:	SAN JACINTO	STATE: CA	ZIP CODE:	92583
CAPACITY:	4	CENSUS:	DATE:	02/07/2026
		UNANNOUNCED	TIME BEGAN:	12:34 PM
MET WITH:	Claudia Rivera, Lead staff		TIME COMPLETED:	02:46 PM

ALLEGATION(S):

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Staff did not prevent resident from inappropriately touching another resident in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alberto Lopez made subsequent unannounced visit to investigate the above-mentioned allegation. LPA met with Claudia Rivera, Lead staff and discussed the purpose of the visit.

On 06/04/2024 Licensing Program Analyst (LPA) Yolanda Delgado made an unannounced visit to the facility to initiate an investigation into the allegation listed above. LPA met with Administrator Adebayo A. Fijabi and explained the purpose of the visit.

LPA interviewed one (1) staff, one (1) client and requested and obtained copies of pertinent documentation. Due to additional interviews and information needed above allegation needs further investigation.
During today's visit, LPA reviewed and obtained copy of staff and client rosters, ABC log, lBSP report interviewed four (4) S#1 – S#4) staff and three (3) clients C#1 – C#3) and took tour of facility.

(continued on 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2026

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 18-AS-20240528084842

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVERSIDE ASC, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: BENSON HOUSE INC #16	FACILITY NUMBER: 331880610
	VISIT DATE: 02/07/2026

NARRATIVE

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(continued from 9099)
The investigation revealed, regarding allegation: Staff did not prevent resident from inappropriately touching another resident in care. It is alleged that a client touches another client inappropriately and staff did not do anything to prevent it.

LPA interviewed four (4) staff and all four (4) staff stated they are aware of C2 behavior and it has been addressed and continues to be addressed. . LPA interviewed three (3) clients and two (2) of three (3) could not corroborate the allegation. C1 stated C2 grabbed C1’s buttocks two weeks ago. C1 stated it happens to staff as well. LPA interviewed four (4) staff and all four (4) staff stated they are aware of client’s “touchy” behavior but have never witness any client touching another client buttocks. S1 stated that on average there are six staff on duty and watching clients very closely. S1 stated that medication has been prescribed for C2 which has help. C2 has been at facility about four years, and the “touchy” behavior is addressed each time and logged into an ABC log. (A = immediately before the behavior. B = consumer’s behavior C = Immediately after behavior). The logs are documented with all behaviors and the intervention for the inappropriate behavior(s). LPA obtained copy of January 2026 monthly behavior consult assessment (IBSP) which clearly identifies the inappropriate behaviors and how staff can address specific behaviors. All four (4) staff stated that C2 is appropriate for the home and will continue to address his “touchy” behaviors. There is insufficient evidence that the facility staff is not preventing client from touching other clients inappropriately.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur therefore the allegation is UNSUBSTANTIATED.

Exit interview conducted and copy of report and appeals rights provided to Claudia Rivera, Lead staff

SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Alberto Lopez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2026

LIC9099 (FAS) - (06/04)

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