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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 421700160
Report Date: 10/04/2022
Date Signed: 10/04/2022 05:14:25 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS NORTH, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/27/2022 and conducted by Evaluator Diego Cortez
PUBLIC
COMPLAINT CONTROL NUMBER: 29-AS-20220927134346
FACILITY NAME:CASA DORINDAFACILITY NUMBER:
421700160
ADMINISTRATOR:BRIAN MCCAGUEFACILITY TYPE:
741
ADDRESS:300 HOT SPRINGS RD.TELEPHONE:
(805) 969-8011
CITY:SANTA BARBARASTATE: CAZIP CODE:
93108
CAPACITY:325CENSUS: 348DATE:
10/04/2022
UNANNOUNCEDTIME BEGAN:
04:40 PM
MET WITH:Brian McCague, AdministratorTIME COMPLETED:
05:30 PM
ALLEGATION(S):
1
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9
Uncleared staff worked at facility
INVESTIGATION FINDINGS:
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13
Licensing Program Analysts (LPAs) Olson and Cortez conducted an initial complaint visit to initiate the investigation. LPAs met with Administrator, Brian McCague, and explained the reason for the visit.

On the allegation: Uncleared staff is working at facility. It was alleged that Staff 1 (S1) was working at the facility without fingerprint clearance, starting in December 2021.

On 9/21/2022, LPA Kontilis conducted a case management visit to confirm an excluded staff was not present or working at the facility. During that visit, LPA Kontilis reviewed the facility fingerprint clearance roster and determined additional staff were working in the facility without fingerprint clearance, including S1. LPA Kontilis cited for fingerprint clearance on 9/21/2022 and issued a civil penalty. S1 was removed from the facility schedule on 09/21/2022.uintil fingerprint clearance is obtained. Administrator stated S1 was terminated on 10/04/2022.
Continued on 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Kelly BurleyTELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Diego CortezTELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2022
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 29-AS-20220927134346
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS NORTH, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: CASA DORINDA
FACILITY NUMBER: 421700160
VISIT DATE: 10/04/2022
NARRATIVE
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Based on the information obtained, this allegation is Substantiated. A citation and civil penalty will not be issued, because this was cited on the 9/21/2022 Case Management Visit.

Exit interview conducted, appeal rights discussed, and a copy of this report issued.

SUPERVISOR'S NAME: Kelly BurleyTELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Diego CortezTELEPHONE: (805) 562-0400
LICENSING EVALUATOR SIGNATURE:

DATE: 10/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2