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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 336412351
Report Date: 07/31/2025
Date Signed: 07/31/2025 08:40:36 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
06/03/2024 and conducted by Evaluator Venus Mixson
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20240603141232
FACILITY NAME:BENSON HOUSE, INC #10FACILITY NUMBER:
336412351
ADMINISTRATOR:AURORA ARZATEFACILITY TYPE:
735
ADDRESS:68215 CORTA RD.TELEPHONE:
(760) 321-1579
CITY:CATHEDRAL CITYSTATE: CAZIP CODE:
92234
CAPACITY:4CENSUS: 4DATE:
07/31/2025
UNANNOUNCEDTIME BEGAN:
08:08 AM
MET WITH:ADMINISTRATOR, NATANAEL HERNANDEZ TIME COMPLETED:
08:48 AM
ALLEGATION(S):
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Staff physically assaulted resident which resulted in injuries
INVESTIGATION FINDINGS:
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On July 31, 2025, Licensing Program Analyst (LPA), Venus Mixson arrived at the facility unannounced and met with Natanael Hernandez, Administrator. LPA explained the reason for the visit was to provide findings for the complaint investigation.

On June 03, 2024, Community Care Licensing received a complaint alleging staff physically assaulted resident which resulted in injuries. During the investigation, LPA conducted interviews, record reviews, and made observations. LPA was not able to interview two staff members who were pertinent to the complaint investigation due not being able to obtain contact.

Regarding the allegation of staff physically assaulted resident which resulted in injuries, it was reported on June 2, 2024, Resident #1 (R1) was assaulted by a staff member. It was reported due to the assault, R1 sustained bruises on their back and face. Information obtained from interview with Administrator denied the allegations. Administrator stated facility staff did not assault R1. Administrator explained that facility staff was conducting a CPI hold due to R1’s aggressive behaviors.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025
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 2
Control Number 18-AS-20240603141232
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
FACILITY NAME: BENSON HOUSE, INC #10
FACILITY NUMBER: 336412351
VISIT DATE: 07/31/2025
NARRATIVE
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During the CPI hold, staff and R1 fell, resulting in R1 sustaining bruises. Further information obtained from interviews with additional staff indicated they do recall the incident and staff did not assault R1. It was explained that R1 was not complying in the CPI hold and staff and R1 fell. After multiple attempts, LPA was unable to contact and interview R1 due to several facility relocations and attending home pass visits over the weekend. Information obtained from interviews with residents stated there were no concerns regarding staff being physically aggressive with residents. Information obtained from additional witness stated R1 returned to the facility from the hospital and there were no documented injuries included in the hospital discharge documentation.
LPA’s review of the records demonstrated there was documentation of an attempted CPI hold on the date and time of incident in question. Additional record reviews confirmed R1 did go to the hospital on the listed date and time, but there were no noted injuries discussed in the hospital discharge orders.

Based on interviews, record reviews, observations, and the inability to interview relevant parties, the allegation that staff physically assaulted resident which resulted in injuries is unsubstantiated. Information obtained was not sufficient to support the listed allegation. Although the allegation may have happened, there is not a preponderance of the evidence to determine if the alleged violation did nor did not occur.

An exit interview was conducted, and a copy of this report was discussed and provided to Natanael Hernandez, Administrator.
SUPERVISORS NAME: Jazmond D Harris
LICENSING EVALUATOR NAME: Venus Mixson
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2