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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565801393
Report Date: 06/17/2022
Date Signed: 06/17/2022 04:33:55 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
03/17/2022 and conducted by Evaluator Kasandra Lopez
PUBLIC
COMPLAINT CONTROL NUMBER: 29-AS-20220317170723
FACILITY NAME:GONZALES FAMILY HOMEFACILITY NUMBER:
565801393
ADMINISTRATOR:VENIE G. GONZALESFACILITY TYPE:
735
ADDRESS:4450 BROWNING DRIVETELEPHONE:
(805) 488-2315
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:6CENSUS: 5DATE:
06/17/2022
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Leonardo TugadeTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Client was sexually abused by another client in the facility
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) KaSandra Lopez conducted an unannounced subsequent complaint visit to deliver findings for the above allegation. LPA met with caregiver Leonardo Tugade and explained the reason for the visit. The LPA contacted the Administrator Venie Gonzales on the telephone at 10:34am and informed her of the complaint findings. The Administrator gave permission for a caregiver to sign the report.

On 03/17/2022, the Department received a complaint regarding an allegation of sexual abuse. It was alleged that Client #1 (C1) was sexually abused by another Client #2 (C2) in the facility. The Licensee submitted an Unusual Incident Report (UIR) to report the allegation. The allegation was also reported to the Oxnard Police Department and Adult Protective Services. The complaint was referred to Community Care Licensing Division’s Investigations Branch (IB) and assigned to Investigator Ryan Miles.

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

DATE: 06/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022
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 2
Control Number 29-AS-20220317170723
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: GONZALES FAMILY HOME
FACILITY NUMBER: 565801393
VISIT DATE: 06/17/2022
NARRATIVE
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On 03/18/2022, from 9:25am to 11:15am, Licensing Program Analyst (LPA) KaSandra Lopez conducted an unannounced initial complaint visit. Tri-Counties Regional Center (TCRC) Quality Assurance Specialist (QAS) Liz Aced-Arnett was also present. The LPA and QAS met with staff Leonardo Tugade at 9:25am and explained the reason for the inspection. Administrator Venie Gonzales was contacted and advised of the reason for the inspection. During the inspection, the LPA and QAS conducted a brief physical plant tour and reviewed records at 9:37am. No immediate health or safety concerns were observed during the inspection. A telephone interview was also conducted with the Administrator at 10:23am.

On 03/29/2022, from approximately 10:55am to 12:14pm, Investigator Miles and Investigator Heidy Bendana conducted interviews with staff, Administrator, clients, and Tri-Counties Regional Center (TCRC) Representatives; and on 03/30/2022, at approximately 11:25am, with C2’s Representative.

Information obtained through Investigator Miles and Bendana’s interviews found that C1 alleged another client of the facility (C2) touched C1 on the buttocks, private area, head, and arm without consent. Administrator stated staff reported to her that C1 was the one who initiated touch with C2 but was denied and got upset. Staff stated C1 appeared to try and get C2 to go into their room but when they were not able to, C1 got upset and left the home. C1 ended up calling 911 to go to the hospital. Information gathered also reflected that C2 is deaf and suffers from a genetic neurological disorder that affects their mental capabilities and capacities. Per C2’s Representative, C2 is unable to “communicate, vocalize, and has limited sign language that C2 may not understand when spoken to. C2 has a tendency in a playful manner, that annoys the other clients, of touching which they may think is inappropriate.”

TCRC Representatives indicated in October 2021, January 2022, and March 2022, C1 had “multiple incidents of inappropriate behavior(s)” displayed in the facility and other places. TCRC Representatives addressed that C1’s inappropriate behavior(s) are occurring “more often” and are finding resolutions to redirect the inappropriate behavior(s). TCRC Representatives and the Administrator addressed the issues with C1 and all agreed that C1 “wants to be placed in a new home”.

Based on the information obtained, C1 has a history of displaying and acting out inappropriate behaviors, along with a history of making false allegations. Based on information gathered, the Department does not have sufficient evidence to determine C1 was sexually abused by C2 in the facility; therefore, the above allegation is deemed Unsubstantiated at this time. Exit interview conducted. A copy of report was emailed.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Kasandra Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2