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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 425801326
Report Date: 06/11/2026
Date Signed: 06/11/2026 04:00:49 PM

Substantiated


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
10/14/2025 and conducted by Evaluator Kristin Kontilis
COMPLAINT CONTROL NUMBER: 29-AS-20251014145002
FACILITY NAME:DEVEREUX CALIFORNIA - ADULT DAY CAREFACILITY NUMBER:
425801326
ADMINISTRATOR:NELLIE JUSTFACILITY TYPE:
775
ADDRESS:6960B FALBERG WAYTELEPHONE:
(805) 968-2525
CITY:GOLETASTATE: CAZIP CODE:
93117
CAPACITY:60CENSUS: 35DATE:
06/11/2026
UNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Jennifer Farley, Program Director; Nellie Just, Program ManagerTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff failed to assist clients with toileting needs.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced subsequent complaint visit to deliver final findings for the above-stated allegations. During today’s visit, LPA met with Program Director Jennifer Farley and Program Manager Nellie Just. LPA explained the purpose of the visit. LPA Kontilis conducted the initial visit on 10/21/2025 from approximately 11:00 am – 3:30 pm at which time LPA conducted interviews and obtained documents pertaining to the investigation.

On the allegation, Staff failed to assist clients with toileting needs: Reporting Party voiced concern that staff are not assisting clients with their toileting needs when clients are between their residential and day programs. Program Director and Program Manager stated conflicts in the past have been addressed with individual staff members regarding staff’s responsibilities and expectations of meeting clients’ toileting needs. Interviews conducted revealed after specific incidents where conflicts of toileting responsibility occurred

Please continue to 9099-C, Pg 2.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2026
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 5
Control Number 29-AS-20251014145002
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 CALIFORNIA - ADULT DAY CARE
FACILITY NUMBER: 425801326
VISIT DATE: 06/11/2026
NARRATIVE
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among staff, staff were advised that staff responsibilities are not program specific and client care is the priority regardless of the location of the client and/or the program in which they are participating. The allegation that staff failed to assist clients with toileting needs is deemed Substantiated at this time.

Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiency was cited (refer to LIC 9099-D):

Exit interview conducted. Copy of report and Appeal Rights issued at the time of the visit.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 29-AS-20251014145002
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 CALIFORNIA - ADULT DAY CARE
FACILITY NUMBER: 425801326
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/11/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/15/2026
Section Cited
CCR
80072(a)(2)
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80072 (a)(2) Personal Rights..., each client shall have personal rights which include, but are not limited to, the following: (2) To be accorded safe, healthful and comfortable acommodations… to meet his/her needs.
This requirement was not met as evidenced by:
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Program Manager agrees to conduct a staff meeting to include staff responsibilities for hygiene care and toileting. Proof of meeting will be submitted via email to LPA to include description of the meeting, date held, first and last names of all attendees.
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Based on record review and interviews conducted, the licensee did not comply with the section cited above when staff engaged in conflict about toileting responsibilities for clients which poses an immediate health and safety risk to clients 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: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
10/14/2025 and conducted by Evaluator Kristin Kontilis
COMPLAINT CONTROL NUMBER: 29-AS-20251014145002

FACILITY NAME:DEVEREUX CALIFORNIA - ADULT DAY CAREFACILITY NUMBER:
425801326
ADMINISTRATOR:NELLIE JUSTFACILITY TYPE:
775
ADDRESS:6960B FALBERG WAYTELEPHONE:
(805) 968-2525
CITY:GOLETASTATE: CAZIP CODE:
93117
CAPACITY:60CENSUS: 35DATE:
06/11/2026
UNANNOUNCEDTIME BEGAN:
10:35 AM
MET WITH:Jennifer Farley, Program Director; Nellie Just, Program ManagerTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff left client in bathroom for an extended period of time.
Staff do not ensure clients are adequately supervised.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced subsequent complaint visit to deliver final findings for the above-stated allegations. During today’s visit, LPA met with Program Director Jennifer Farley and Program Manager Nellie Just. LPA explained the purpose of the visit. LPA Kontilis conducted the initial visit on 10/21/2025 from approximately 11:00 am – 3:30 pm at which time LPA conducted interviews and obtained documents pertaining to the investigation.

On the allegation, Staff left client in the bathroom for an extended period of time: Reporting Party voiced concern that Resident 1 (R1) was left unattended in the bathroom for “around 50-60 minutes”. Interviews conducted revealed R1 uses the bathroom regularly while attending the day program and R1’s toileting time regularly takes a significant amount of time, even as much as 30-40 minutes. Interviews conducted further revealed, staff are aware of R1’s toileting practices and when R1 is in the bathroom, they observe R1’s privacy, allow R1 to void, and check on R1 every 3-5 minutes and every 5-10 minutes. Interviews
Please continue to 9099-C, Pg 2.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 29-AS-20251014145002
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 CALIFORNIA - ADULT DAY CARE
FACILITY NUMBER: 425801326
VISIT DATE: 06/11/2026
NARRATIVE
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conducted revealed R1 communicates with staff when toileting is complete or when more time is needed. Interviews conducted revealed Staff have not left R1 unattended in the bathroom for more than 5-10 minutes at a given time. Therefore, the allegation that staff left client in the bathroom for an extended period of time is deemed Unsubstantiated at this time.

On the allegation, Staff do not ensure clients are adequately supervised: Reporting Party voiced concern that on one given afternoon, clients were left unattended in the activity room, and it was unknown where the staff were. Interviews conducted revealed that the structure of the day program allows wide range supervision of the clients; there are clients who can freely move about the facility independently; and there are clients who have one-to-one staffing. Interviews conducted further revealed staff communicate amongst themselves as well as with the Staff-in-Charge (SIC) when they need to step away to ensure the clients are supervised. Program Director and Program Manager confirmed staff are shared within the programs to alleviate any staffing shortages to ensure client safety at all times. Therefore, the allegation, Staff do not ensure clients are adequately supervised is deemed Unsubstantiated at this time.

Exit interview conducted. No deficiencies noted. Copy of report issued at the time of the visit.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:

DATE: 06/11/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/11/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5