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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 421703549
Report Date: 11/12/2025
Date Signed: 11/12/2025 01:34:24 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
11/07/2025 and conducted by Evaluator Mark Jeffries
COMPLAINT CONTROL NUMBER: 29-AS-20251107163849
FACILITY NAME:DEVEREUX FOUNDATION - WEISMAN CENTER (RCFE)FACILITY NUMBER:
421703549
ADMINISTRATOR:ENEDILIA AVILAFACILITY TYPE:
740
ADDRESS:6960 DEVEREUX WAYTELEPHONE:
(805) 879-0338
CITY:GOLETASTATE: CAZIP CODE:
93117
CAPACITY:15CENSUS: DATE:
11/12/2025
UNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Administrator, Enedilia AvilaTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Staff did not provide responsible party with resident's records.
INVESTIGATION FINDINGS:
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 At 9:00am on 11/12/2025, Licensing Program Analyst (LPA) Jeffries arrived unannounced to conduct an initial investigation visit pertaining to the allegation listed on this complaint. LPA met with Administrator, Enedilia Avila (S1) and Program Director, interim Program Manager, Sydney Steiner (S2), Case Manager, Monica Gomez (S3), Quality Manager, Eric Christensen (S4), announced who he is and the reason for the visit.
LPA conducted interviews with Administrative staff. LPA requested and reviewed documentation. LPA presented a written request for documentation pertaining to Resident 1 (R1) from R1'a responsible party (F1). Facility staff secured R1's facility file and presented documents to LPA. LPA noted that some of the documents requested were visually confirmed to have additional residents names and additional residents information and were not collected to protect the identities of individuals not related to the allegation to this complaint. LPA requested an itemized explanation for documents not collected per the responsible parties written request via email to the LPA's email no later than end of business day of November 14, 2025. CONTINUED on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Mark Jeffries
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2025
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 29-AS-20251107163849
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: DEVEREUX FOUNDATION - WEISMAN CENTER (RCFE)
FACILITY NUMBER: 421703549
VISIT DATE: 11/12/2025
NARRATIVE
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 As to the allegation of, "Staff did not provide responsible party with resident's records" It was alleged that, this facility has "not (provided) their internal and actual records recordings/documentation by (the facility) personnel." It was discovered through interviews on 11/12/2025 of Administrative Staff S1, S2, S3, and S4 that Resident 1 (R1) resided at the facility from June 2023 through November 21, 2025. On 11/12/2025, It was also determined through interviews with S1, S2, S3, and S4, that R1's responsible party (F1) was confirmed. LPA Jeffries presented a written request for documentation not previously provided to the facility from F1 for R1 additional documentation requested. Administrative staff presented LPA with all documents requested for R1 in F1's written request. LPA noted that documentation on written request that had resident information in addition to R1 which was visually verified by LPA. LPA noted that facility has presented documentation to F1 for R1 prior to this allegation as noted in an interview on 11/10/2025 by LPA with F1,, and noted in the initial complaint filed as well as emails collected by LPA on 11/12/2025 from facility Administrative Support Coordinator Mory Alvarez. LPA noted that documentation that could be sent to F1 per F1's written request was collected and documents with confidential information of residents that included R1 was visually verified by LPA on 11/12/2025. Additionally, facility provided an explanation of documentation for not sent to F1 due to additional resident privet information on those documents in an email to F1 explaining that documents not provided per the written request were due to resident privacy rights indicating that other resident information were noted on documents that were not provided. Based on the admission of F1 on 11/10/2025 of prior documents submitted by evidence of previous documentation submitted to F1 by past emails provided by Administrative Support Coordinator, and the email submission of documents to F1 written request on the complaint visit on 11/12/2025, there is not sufficient evidence at this time to support the allegation of, "Staff did not provide the responsible party with resident's records." and is unsubstantiated at this time.

Exit interview, report read, and report provided.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Mark Jeffries
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2