565800253-5-15-2024-29-AS-DPEA-D5PNXZ-20240528105158

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565800253
Report Date: 05/15/2024
Date Signed: 05/15/2024 02:27:26 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
12/15/2023 and conducted by Evaluator Brian Balisi

COMPLAINT CONTROL NUMBER: 29-AS-20231215135350

FACILITY NAME:	ASSOCIATION FOR RETARDED CITIZENS - VENTURA		FACILITY NUMBER:	565800253
ADMINISTRATOR:	MITCHEL GARCIA		FACILITY TYPE:	775
ADDRESS:	3340 E. LOS ANGELES AVENUE		TELEPHONE:	(805) 527-1358
CITY:	SIMI VALLEY	STATE: CA	ZIP CODE:	93063
CAPACITY:	90	CENSUS: 28	DATE:	05/15/2024
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Mitchel Garcia		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff handled a client in a rough manner.

Staff yelled at a client.

Staff used inappropriate language toward a client.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Brian Balisi conducted a subsequent complaint visit to the above facility. The purpose of the visit is to deliver findings for the above allegations. LPA M. Arroyo conducted an initial complaint visit on 12/21/2023, and a subsequent visit was conducted on 05/02/2024 by LPAs Martha Arroyo and Brian Balisi. On today's visit, LPA Balisi met with Program Manager, Mitchel Garcia and Case Manager, Ashleigh Chenault. Entrance interview.

During the initial visit on 12/21/2023, LPA M. Arroyo conducted a plant tour at 10:30 a.m., conducted interviews with seven (7) staff members between 10:50 a.m. and 11:55 p.m., conducted a file review at 10:40 a.m., and obtained copies of pertinent documents. On 05/02/2024, LPAs M. Arroyo and B. Balisi conducted a plant tour at 1:23 p.m., conducted interviews with the Program Manager and four (4) randomly selected participants between 1:15 p.m. and 2:10 p.m., and obtained copies of pertinent documents. LPA Arroyo also conducted telephonic interviews with family members on 05/06/2024 at 3:50 p.m., 4:08 p.m., and 4:22 p.m.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024

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-20231215135350

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: ASSOCIATION FOR RETARDED CITIZENS - VENTURA	FACILITY NUMBER: 565800253
	VISIT DATE: 05/15/2024

NARRATIVE

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Continued from 9099

It was alleged that staff handled a client in a rough manner. It was reported that Participant #1 (P1) grabbed an item belonging to someone else and Staff #1 (S1) told P1 to give it back. Additionally, S1 held P1’s arms in an attempt to rip the item out of P1’s hands. Records review of P1’s physician’s report dated 10/10/2023, indicates P1’s primary diagnosis is severe developmental delay. Interviews conducted with staff revealed that P1 can be assertive and demanding at times and added that P1 tends to grab things and can become possessive. However, staff stated they are constantly re-directing P1 as well as all the other participants. Additional interviews conducted with staff revealed that none of the clients have ever reported any problems or complaints amongst themselves regarding S1 or anyone else. Interviews conducted with randomly selected participants revealed that they enjoy coming to the day program and stated that staff are nice. Additionally, during interviews, participants reported feeling safe while at the day program. Interviews conducted with family members revealed that staff are good with all the participants that attend, and the participants enjoy attending the day program. Furthermore, family members reported having no concerns with the staff. 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 violations did or did not occur, therefore the above allegation “staff handled a client in a rough manner” is deemed Unsubstantiated at this time

It was also alleged that staff yelled at a client and staff used inappropriate language toward a client. It was reported that P1 grabbed an item belonging to someone else and S1 told P1 to give it back. S1 raised their voice at P1 and began counting in an attempt to seemingly scare P1. Interviews conducted with staff revealed that there are usually three (3) or four (4) participants and staff members in an activity room doing activities. Additionally, during community outings, multiple participants and staff are together as a group. Interviews conducted with randomly selected participants revealed that they enjoy coming to the day program and stated that staff are nice. Additionally, during interviews, participants reported feeling safe while at the day program. Interviews conducted with family members revealed that participants enjoy sharing their day at the day program with them. They added that participants love the staff and have nothing but good things to say. Family members added that participants have not reported staff saying anything mean or hurting them or the other participants. Furthermore, family members reported having no concerns with the staff. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegations.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20231215135350

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: ASSOCIATION FOR RETARDED CITIZENS - VENTURA	FACILITY NUMBER: 565800253
	VISIT DATE: 05/15/2024

NARRATIVE

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Continued from 9099-C

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegations “staff yelled at a client” and “staff used inappropriate language toward a client” are deemed Unsubstantiated at this time.

Exit interview conducted. Report was reviewed and a copy was issued.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024

LIC9099 (FAS) - (06/04)

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