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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 425801165
Report Date: 12/18/2024
Date Signed: 12/18/2024 12:30:44 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
11/21/2024 and conducted by Evaluator Brian Phillips
COMPLAINT CONTROL NUMBER: 29-AS-20241121115753
FACILITY NAME:BAUER RESIDENTIAL SANTA MARIA IFACILITY NUMBER:
425801165
ADMINISTRATOR:CLINTON CADLEFACILITY TYPE:
735
ADDRESS:943 SUNRISE DRIVETELEPHONE:
(805) 934-1089
CITY:SANTA MARIASTATE: CAZIP CODE:
93455
CAPACITY:4CENSUS: 3DATE:
12/18/2024
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Karina Jacobs, Caregiver/Direct Support StaffTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff member is not according privacy to resident(s) in care.
INVESTIGATION FINDINGS:
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On 12/18/2024, Licensing Program Analyst (LPA) Brian Phillips conducted an unannounced subsequent complaint investigation visit to the facility above. LPA arrived at the facility, met with Caregiver/DSP Karina Jacobs and the Administrator was unavailable, and announced the purpose of the visit.

On the allegation: Staff member is not according privacy to resident(s) in care. It is alleged that facility staff have been taking videos and pictures of clients in care at the facility on their cellphone(s). Reporting Party (RP) stated this allegation should have been included with closed complaint #29-AS-20241031151222 regarding the allegation "Licensee allows staff to work and live at the facility without fingerprint clearance” but that RP forgot to include this allegation with attached images and video.

Licensing Agency received image, audio, and video files with the complaint allegation that appear to show a shirtless male standing in a restroom area with no shirt on and wearing a diaper/shorts. According to the allegation, the video/audio was taken by staff in the facility. Continued on 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Brian Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2024
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 3
Control Number 29-AS-20241121115753
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: BAUER RESIDENTIAL SANTA MARIA I
FACILITY NUMBER: 425801165
VISIT DATE: 12/18/2024
NARRATIVE
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On 11/26/2024, Licensing Program Analyst (LPA) Brian Phillips conducted an unannounced initial complaint investigation visit to the facility above. During this visit, LPA conducted observations of the restroom areas of the facility as in the allegations to this complaint pictures of clients were allegedly taken in the facility restroom. LPA took pictures of the facility restrooms to see if the areas were like the locations in the allegation pictures. LPA took multiple pictures from different angles in both restrooms in the facility. The image/video in the allegation of clients took place in a restroom. This can be observed through the client standing in front of a shower, next to a toilet and sink area. LPA observed that the image/video from the complaint allegation appeared to be taken in the restroom of the facility located in the front hallway next to the main dining room and living room area of the facility. LPA observed that the shower curtain in the facility restroom matched the shower curtain shown behind the client in the image/video, and that the facility restroom had the same color walls, floors, and positioning of shower, toilet, and sink. LPA also observed that the specific shape of the tile cut around the toilet in the facility restroom matched the image/video of the client exactly. LPA did not observe any video or audio evidence within the images/videos that indicated they were being taken for medical reasons including the documenting of an injury to the resident or physical concern. There was nothing in the images/videos to indicate they were taken for an appropriate reason within the facility. LPA requested and received pertinent documentation for record review from the facility including signed and dated Client Consent to be Photographed documents for each client. These consent forms state that the client consents to be photographed by the facility and employees. While in care at the facility, the clients authorize that the photographs/audio recordings made as a result of the consent will be used only by employees for education, training, research, public relations, and/or fundraising. The photo/video in the complaint is of a client not fully clothed standing in the facility restroom. There is no evidence that the photo/video was used for any of the purposes listed in the consent forms. The photo/video was also being possessed by RP who indicated that the photo/video was shared/distributed among staff members. LPA was told by Staff that they believed multiple complaints, and several allegations are being reported to the Licensing Agency due to internal divisions/grudges between certain Staff members at the facility and previous divisions between staff, relatives of staff, and significant others of staff at various facilities run by the Licensee. Staff interviewed by LPA also stated that they would have no reason to take a photo/video of any client unless there were some physical injury or for a body check reason including visible marks. Staff also stated that they would not take photos/videos unless there was something out of the ordinary physically on each client. Body checks do occur during bathing in the restroom, but photos/videos are not usually taken. Based on the information gathered, there is sufficient evidence to prove the alleged violation occurred. Therefore, the allegation is substantiated. Exit interview conducted. Copy of this report provided to the facility.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Brian Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 29-AS-20241121115753
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: BAUER RESIDENTIAL SANTA MARIA I
FACILITY NUMBER: 425801165
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/18/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/19/2024
Section Cited
CCR
80072(a)(1)
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80072(a)(1) Personal Rights. (a) …each client shall have personal rights which include, but are not limited to, the following: (1) To be accorded dignity in his/her personal relationships with staff and other persons.
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Licensee agrees to provide evidence to LPA of plan to address staff cell phone policy including clear reasons why photos/video can be taken for medical reasons injuries etc. Licensee will provide evidence to LPA of scheduled client personal rights training for all staff.
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This requirement is not met based on interviews and record review, licensee did not comply with the section cited above when staff recorded images/videos of client in state of undress without visible injury which posed an immediate health and safety risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Brian Phillips
LICENSING EVALUATOR SIGNATURE:

DATE: 12/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/18/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3