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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565801544
Report Date: 07/15/2024
Date Signed: 07/15/2024 10:44:27 AM

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
05/21/2024 and conducted by Evaluator Martha Arroyo
COMPLAINT CONTROL NUMBER: 29-AS-20240521141247
FACILITY NAME:ARC OF VENTURA COUNTY - OXNARD, THEFACILITY NUMBER:
565801544
ADMINISTRATOR:JUAN GARCIAFACILITY TYPE:
775
ADDRESS:416 NORTH "A" STTELEPHONE:
(805) 240-1620
CITY:OXNARDSTATE: CAZIP CODE:
93030
CAPACITY:90CENSUS: 75DATE:
07/15/2024
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Celine GarciaTIME COMPLETED:
10:45 AM
ALLEGATION(S):
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Staff did not prevent client from being harmed by another client.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Martha Arroyo conducted a subsequent complaint visit to the above facility. The purpose of the visit is to deliver findings for the above allegation. The initial complaint visit was conducted on 05/29/2024 by LPA M. Arroyo. On today's visit, LPA Arroyo met with Case Manager, Celine Garcia. Entrance interview.

During the initial visit on 05/29/2024, LPA Arroyo toured the facility at 12:40 p.m., conducted interviews with one (1) staff and three (3) participants between 1:35 p.m. and 2:25 p.m., conducted a participant file review at 12:55 p.m., and obtained copies of pertinent documents. On 06/21/2024, LPA Arroyo conducted a telephonic interview with one staff member at 8:55 a.m.

Report Continued on LIC 9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
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Control Number 29-AS-20240521141247
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: ARC OF VENTURA COUNTY - OXNARD, THE
FACILITY NUMBER: 565801544
VISIT DATE: 07/15/2024
NARRATIVE
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Report Continued from LIC 9099...

It was alleged that staff did not prevent client from being harmed by another client. It was reported that Participant #1 (P1) struck Participant #2 (P2) on the shoulder. Interviews conducted with staff revealed that this was the first incident observed between P1 and P2. Staff stated that after speaking with both participants, P1 did not have a motive for tapping P2 on the shoulder. Interviews conducted with participants revealed that staff addressed P1’s actions following the incident while redirecting both P1 and P2. Further interviews revealed that P1 apologized to P2 after being redirected by staff and realizing what they had done. During an interview, P2 reported having a bad day, but was reminded by staff that hitting others was not nice. Additionally, all participants present during the incident stated they had no concerns with the facility or staff and stated that they enjoyed attending the day program. Furthermore, P1 and P2 reported feeling safe around each other while at the day program. Based on the information obtained and reviewed, the Department does not have sufficient evidence to support the allegation of “staff did not prevent client from being harmed by another client”. Therefore, this allegation is being deemed Unsubstantiated at this time.

Exit interview. No citations issued. Report was reviewed and a copy was issued.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2024
LIC9099 (FAS) - (06/04)
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