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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565801259
Report Date: 07/15/2025
Date Signed: 07/15/2025 02:46:25 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 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
11/19/2024 and conducted by Evaluator Emily Peraldi
COMPLAINT CONTROL NUMBER: 29-AS-20241119154815
FACILITY NAME:MG2 FAMILY HOMEFACILITY NUMBER:
565801259
ADMINISTRATOR:MARIA MIRANDAFACILITY TYPE:
735
ADDRESS:5031 HALSEY WAYTELEPHONE:
(805) 488-6527
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:6CENSUS: 6DATE:
07/15/2025
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Maria MirandaTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Resident is not afforded dignity and respect in their personal relationships with staff.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Emily Peraldi and Angela Barutyan conducted an unannounced subsequent complaint visit to this facility. At 10:35 a.m., the LPAs arrived at the facility and called Administrator, Maria Miranda and explained the reason for the visit. At 10:48 a.m., the Administrator arrived at the facility.

During the initial visit conducted on 11/26/2024 between 10:05 a.m. and 12:00 p.m., the LPA along with Quality Assurance Specialist (QAS) Tri-Counties Regional Center Patrick Brown conducted a physical plant tour and an interview with the Administrator, Jose Ong. During today’s visit, starting at 10:56 a.m., the LPAs conducted a physical plant tour. Between 11:32 a.m. and 2:28 p.m., the LPAs conducted interviews with the Administrator, three (3) staff and four (4) clients. During both visits, the LPA requested and obtained copies of pertinent documents. Continued on LIC 9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025
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 2
Control Number 29-AS-20241119154815
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: MG2 FAMILY HOME
FACILITY NUMBER: 565801259
VISIT DATE: 07/15/2025
NARRATIVE
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Regarding the allegation: 1.) Resident is not afforded dignity and respect in their personal relationships with staff. It was alleged that Staff #1 (S1) would take Client #1 (C1) to S1’s personal home during the weekend for two or three hours. Interview with both Administrators, Maria Miranda and Jose Ong denied the allegation and stated that they have not observed or heard of S1 taking C1 to their personal home. Administrators explained that on the weekends, two (2) to three (3) staff take clients on outings such as the beach or shopping. The Administrator, Jose Ong stated that staff do not leave clients unsupervised, especially during an outing or activity. Interview with S1 denied the allegation. Interview with C1 did not reveal any concerns. Interviews with other clients did not reveal any concerns. The information obtained during the investigation did not include evidence sufficient to corroborate the allegation. Although the allegation may have happened or is valid, there is not sufficient evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed Unsubstantiated at this time.

Exit interview conducted. A copy of the report was provided.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2