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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565800394
Report Date: 02/17/2022
Date Signed: 02/17/2022 04:26:28 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
06/26/2020 and conducted by Evaluator Kasandra Lopez
COMPLAINT CONTROL NUMBER: 29-AS-20200626153542
FACILITY NAME:BROWN BOARD & CAREFACILITY NUMBER:
565800394
ADMINISTRATOR:BETTINA BROWNFACILITY TYPE:
735
ADDRESS:1337 W. HILL STREETTELEPHONE:
(805) 302-0232
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:10CENSUS: 9DATE:
02/17/2022
UNANNOUNCEDTIME BEGAN:
12:41 PM
MET WITH:Bettina BrownTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff smoking cigarettes in facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) KaSandra Lopez conducted an unannounced subsequent complaint inspection to deliver the above findings. The LPA met with Administrator Bettina Brown and explained the reason for the visit.

During the initial 10-day virtual inspection on 07/01/2020, the LPA conducted a virtual physical plant inspection and conducted an interview with the Administrator. The allegation of ‘Staff smoking in the facility” alleges Administrator Bettina Brown smokes cigarettes in the facility and the home smells like smoke. During the interview with the Administrator on 07/01/2020, the Administrator admitted to smoking cigarettes in the facility in her office but denied smoking near the clients. During today's inspection, the Administrator stated they were not aware they should not smoke cigarettes in the facility and no longer does so.

Report continued on LIC 9099-C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Kasandra Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
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-20200626153542
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: BROWN BOARD & CARE
FACILITY NUMBER: 565800394
VISIT DATE: 02/17/2022
NARRATIVE
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Based on the information obtained there is sufficient evidence to support the allegation of Staff smoking in the facility. Therefore, the allegation is substantiated. Pursuant to Title 22 CA Code of Regulations, the following deficiency was cited (refer to LIC 9099-D). Exit interview conducted and the report reviewed with the Administrator. A copy of the report was emailed.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Kasandra Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 29-AS-20200626153542
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: BROWN BOARD & CARE
FACILITY NUMBER: 565800394
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/17/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/22/2022
Section Cited
CCR
80072(a)(2)
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80072 Personal Rights (a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement is not met as evidenced by:
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The Administrator agrees to review regulation 80072 and submit a written memo of understanding of the regulation to CCl by 2/22/2022.
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Based on interviews, the licensee failed to comply with the section cited above, as the Administrator smokes cigarettes in the facility office which poses a health, safety, and personal rights violation 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: Desaree Perera
LICENSING EVALUATOR NAME: Kasandra Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
LIC9099 (FAS) - (06/04)
Page: 2 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
06/26/2020 and conducted by Evaluator Kasandra Lopez
COMPLAINT CONTROL NUMBER: 29-AS-20200626153542

FACILITY NAME:BROWN BOARD & CAREFACILITY NUMBER:
565800394
ADMINISTRATOR:BETTINA BROWNFACILITY TYPE:
735
ADDRESS:1337 W. HILL STREETTELEPHONE:
(805) 302-0232
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:10CENSUS: 9DATE:
02/17/2022
UNANNOUNCEDTIME BEGAN:
12:41 PM
MET WITH:Bettina BrownTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff smoking marijuana with resident.
Facility is in disrepair.
Staff did not administer medication to resident.
Facility is in financial distress.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) KaSandra Lopez conducted an unannounced subsequent complaint inspection regarding the above allegations. The LPA met with Administrator Bettina Brown and explained the reason for the visit.

During the initial 10-day virtual inspection on 07/01/2020, the LPA conducted a virtual physical plant inspection and conducted an interview with the Administrator. During today’s inspection the LPA conducted interviews with five residents and Staff # 1(S1) between 12:45 PM and 2:00 PM.

The allegation of 'Staff is smoking marijuana with resident" alleges S1 has smoked marijuana with a resident in the facility. Interviews revealed no observations of staff and residents smoking marijuana together at the facility. During the interview with S1, S1 denied ever smoking marijuana with any residents in the home. There is insufficient evidence to support the allegation occurred. Therefore, the allegation is deemed unsubstantiated at this time. Report continued on LIC 9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Kasandra Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 29-AS-20200626153542
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: BROWN BOARD & CARE
FACILITY NUMBER: 565800394
VISIT DATE: 02/17/2022
NARRATIVE
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The allegation of 'Facility is in disrepair' alleges appliances are constantly broken with the washing machine and kitchen sink most recently not working. During the virtual inspection on 07/01/2020, the LPA observed the washing machine and kitchen sink to be operational. During that inspection, the Administrator stated the washing machine and kitchen sink were recently repaired but stated the repairs were conducted timely within a few days and it had no impact on the residents. Interviews today revealed no issues or concerns with appliances functioning properly at the home or the home not being repaired timely. During today's inspection and during the previous Required Annual inspection on 12/28/2021, the LPA observed the washing machine and other appliances in the home to be operational. There is insufficient evidence to support the allegation occurred. Therefore, the allegation is deemed unsubstantiated at this time.

The allegation of 'Staff did not administer medication to resident" alleges a resident at the home was not getting their medications and was administering their own medication. During the 07/01/2020 virtual inspection, the LPA observed resident medications to be centrally stored and locked in the office. During today's inspection and during the Annual inspection on 12/28/2021, the LPA observed all medications to be locked and centrally stored in the office and did not observe any medications in resident rooms. Interviews revealed all medications are kept locked in the office and no issues or concerns regarding residents not receiving their medications timely. There is insufficient evidence to support the allegation occurred. Therefore the allegation is deemed unsubstantiated.

The allegation of 'Facility is in financial distress' alleges the licensee's utilities are past due for payment. Interviews with the Administrator revealed no issues with utility payments and stated the facility has never been without utilities. Interviews conducted today, revealed the home always has water, heating, and electricity and there has not been any issues or concerns regarding utilities. There is insufficient evidence to support the allegation occurred. Therefore, the allegation is deemed unsubstantiated.

Exit interview conducted and report reviewed with the Administrator. A copy of the report will be emailed.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Kasandra Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 5