561702356-9-9-2025-29-AS-KHEN-DLYVZ2-20250929165200

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 561702356
Report Date: 09/09/2025
Date Signed: 09/09/2025 01:50:56 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
08/20/2025 and conducted by Evaluator Kelly Dulek

COMPLAINT CONTROL NUMBER: 29-AS-20250820115715

FACILITY NAME:	COTTONWOOD, THE		FACILITY NUMBER:	561702356
ADMINISTRATOR:	FLORO P CORTES JR		FACILITY TYPE:	735
ADDRESS:	1417 LIRIO AVENUE		TELEPHONE:	(805) 647-6046
CITY:	SATICOY	STATE: CA	ZIP CODE:	93004
CAPACITY:	24	CENSUS: 22	DATE:	09/09/2025
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Romy Sapida, facility staff		TIME COMPLETED:	02:05 PM

ALLEGATION(S):

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Staff does not safeguard client's personal belongings

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kelly Dulek conducted an unannounced subsequent complaint visit for the allegation listed above. Upon arrival, LPA met with facility staff Romy Sapida and explained the reason for the visit. Administrator was contacted via telephone and was unavailable during today's visit. Entrance interview conducted.

During today’s visit, LPA interviewed Administrator telephonically at 01:02PM and LPA obtained photographs of relevant items. During an initial complaint visit conducted on 08/28/2025, LPA interviewed Administrator telephonically at 02:37PM, interviewed staff at 02:42PM, toured the facility with facility staff at 02:45PM, and interviewed clients from 02:54PM to 03:35PM. The following was then determined:

Report Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20250820115715

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: COTTONWOOD, THE	FACILITY NUMBER: 561702356
	VISIT DATE: 09/09/2025

NARRATIVE

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The complaint alleges that Client #1 (C1) took money from Client #2 (C2), who is their roommate. LPA interviewed both clients during the investigation. Both C1 and C2 confirmed that C1 cashed C2’s check and did purchase something for themselves using the money. Both clients confirmed the facility did not give C1 access to C2’s check. This was brought up to C2’s case worker and the case worker resolved C2’s concern. All clients interviewed indicated that they get their checks weekly and they cash their own checks. Clients stated they handle their own cash and make their own purchases. Interview with Administrator revealed that checks are mailed to the facility for the clients. The staff then have the clients sign for their checks when they receive them and each client cashes their own check at a local establishment. Staff interviewed indicated that they do not receive C2’s check by mail. Instead, C2’s caseworker receives C2’s check and after cashing the check and assisting C2 in making an initial purchase, the caseworker gives the facility C2’s remaining cash for safekeeping. C2 then signs out their money from the staff when they request cash. LPA confirmed the facility does keep a log of transactions for C2. It is unclear how long the facility has been safeguarding C2’s cash, however staff stated that they believe it was due to a concern with C1 taking C2’s money previously. LPA inquired with both C1 and C2 when the incident occurred and neither could recall. C2 stated there have been no problems since the one time and that was resolved. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the above allegation “Staff does not safeguard client’s personal belongings” is deemed UNSUBSTANTIATED at this time.

No citations issued. Exit interview conducted. A copy of today’s report was provided.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2025

LIC9099 (FAS) - (06/04)

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