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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565801271
Report Date: 01/06/2022
Date Signed: 01/06/2022 03:39:18 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
08/19/2021 and conducted by Evaluator Kasandra Lopez
COMPLAINT CONTROL NUMBER: 29-AS-20210819095519
FACILITY NAME:VOCATIONAL SKILLS SERVICES, INC.-ADP/OXNARDFACILITY NUMBER:
565801271
ADMINISTRATOR:LAILANI G. MACASIASFACILITY TYPE:
775
ADDRESS:549 WEST HUENEME ROADTELEPHONE:
(805) 986-8300
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:36CENSUS: 25DATE:
01/06/2022
UNANNOUNCEDTIME BEGAN:
01:35 PM
MET WITH:Lailani MacasiasTIME COMPLETED:
02:20 PM
ALLEGATION(S):
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Staff hit a client while in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) KaSandra Lopez conducted an unannounced subsequent complaint inspection to deliver the findings regarding the above allegation. The LPA met with Administrator Lailani Macasias and explained the reason for inspection.

The allegation of 'Staff hit a client in care' alleges Staff #1 (S1) slapped Client #1 (C1) on the face during an outing. On 08/27/2021, the LPA initiated the investigation and conducted an inspection at the day program and interviewed the Administrator. The LPA also conducted a Collateral inspection on this day and interviewed Client #1 (C1). On 09/08/2021, the LPA conducted a subsequent inspection and interviewed Staff #1 (S1). Interviews revealed the alleged incident occurred during an outing with S1, C1, and Client #2 (C2) present as C1 only attended community based outings with S1. The LPA attempted to interview C2 but C2 has not attended the day program since August and lives in a private residence.

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

DATE: 01/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2022
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 2
Control Number 29-AS-20210819095519
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: VOCATIONAL SKILLS SERVICES, INC.-ADP/OXNARD
FACILITY NUMBER: 565801271
VISIT DATE: 01/06/2022
NARRATIVE
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During the interview with S1, S1 denied ever slapping C1 or hitting or touching C1 in an inappropriate manner. Interviews with the Administrator revealed S1 was a long time employee and had no history of complaints by the clients. During the interview with C1, C1 was unclear about the event(s) that took place and individual(s) involved.

Based on the information obtained, there is insufficient evidence to support the allegation occurred. Therefore, the allegation of 'Staff hit a client while in care' is deemed unsubstantiated at this time. Exit interview and report reviewed with the Administrator. A copy of the report and appeal rights will be emailed.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Kasandra Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2