336412350-3-28-2026-18-AS-RORN-DSQV7X-20260401161151

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 336412350
Report Date: 03/28/2026
Date Signed: 03/28/2026 04:55:20 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
10/04/2024 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 18-AS-20241004163936

FACILITY NAME:	BENSON HOUSE, INC #9		FACILITY NUMBER:	336412350
ADMINISTRATOR:	AURORA ARZATE		FACILITY TYPE:	735
ADDRESS:	68615 VISTA CHINO		TELEPHONE:	(760) 327-3715
CITY:	CATHEDRAL CITY	STATE: CA	ZIP CODE:	92234
CAPACITY:	4	CENSUS: 4	DATE:	03/28/2026
		UNANNOUNCED	TIME BEGAN:	11:40 AM
MET WITH:	Vanessa Velez, Assistant Manager		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Client sustained injury while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent visit to deliver findings for the allegation listed above. LPA met with Staff, Vanessa Velez, and explained the purpose of the visit.

The investigation consisted of the following:
On 10/9/24, LPA A. Zerbo conducted the initial visit. On 12/16/24, LPA S. Jeon made a follow-up visit and interviewed two (2) staff, one (1) client, and reviewed documents for Client #1. LPA Chan interviewed additional two (2) staff and three (3) clients via telephone on different dates. LPA interviewed another client during the visit today.

The investigation revealed the following:
Allegation - Client sustained injury while in care. It was alleged that staff injured Client #1 (C1) in the arm during a CPI hold. Interviews with the staff and clients, along with documents, were used to determine the findings.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2026

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-20241004163936

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 #9	FACILITY NUMBER: 336412350
	VISIT DATE: 03/28/2026

NARRATIVE

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LPA Jeon interviewed both the staff who initiated the Crisis Protected Intervention (CPI) hold on C1 in October of 2024. According to both staff, C1 was physically aggressive towards anyone nearby. Staff applied the CPI hold for a few minutes and released C1 after calming down. Staff denied grabbing C1 during the CPI hold. LPA obtained a copy of the incident report submitted to Inland Regional Center and licensing. The report stated that after the CPI restraint, C1 ran to the room. On the same day, C1 walked over to the main office with staff following and stated that he/she had a bruise. Staff observed a purple bruise in the inner elbow about the size of a dime and asked C1 if he/she wanted medical assistance, which C1 replied no. Staff noted that C1 admitted the next day that the injury was done to himself/herself. Although C1 had a bruise, the origin of the bruise cannot be determined.

LPA Chan interviewed additional staff who stated they have not performed a CPI hold on the clients. Staff stated they received training on the proper CPI techniques and were able to explain the process during and after a CPI hold. The clients interviewed like living at the facility and stated that the staff are good with them. C1 did not recall the CPI hold in the past or staff causing any injury to the client. The other 3 clients have not been restrained by staff.

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.

An exit interview was conducted with V. Velez. A copy of this report, along with the appeal rights, was provided.

SUPERVISORS NAME: Tony Vasallo
LICENSING EVALUATOR NAME: Cynthia D Chan
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2026

LIC9099 (FAS) - (06/04)

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