<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565801924
Report Date: 08/22/2023
Date Signed: 08/22/2023 03:45:32 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
04/05/2023 and conducted by Evaluator Teresa Camara
COMPLAINT CONTROL NUMBER: 29-AS-20230405080656
FACILITY NAME:ABUTIN CARE HOME IIFACILITY NUMBER:
565801924
ADMINISTRATOR:BENJAMIN G. ABUTIN JR.FACILITY TYPE:
735
ADDRESS:1830 W. HILL STREETTELEPHONE:
(805) 985-4832
CITY:OXNARDSTATE: CAZIP CODE:
93035
CAPACITY:6CENSUS: 6DATE:
08/22/2023
UNANNOUNCEDTIME BEGAN:
02:54 PM
MET WITH:Joyce AbutinTIME COMPLETED:
03:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff hit resident on face
Facility staff handled resident in a rough manner
Facility staff used inappropriate restraint on resident
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Teresa Camara conducted a subsequent complaint investigation visit. LPA met with administrator Joyce Abutin and explained the reason for the visit.

On 4/13/2023, LPA conducted an initial complaint investigation visit, reviewed records, and interviewed co-administrators Ben and Joyce Abutin and two clients. On 7/11/2023, LPA conducted a phone interview with administrator Joyce Abutin. On 7/13/2023, LPA conducted interviews with Staff 1 (S1), Staff 2 (S2) and a witness. On 8/18/2023, LPA conducted an interview away from the facility with Client 1 (C1).


(continued on 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jeralyn Ann Pfannenstiel
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023
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-20230405080656
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: ABUTIN CARE HOME II
FACILITY NUMBER: 565801924
VISIT DATE: 08/22/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
(continued from 9099)

During the interviews with administrators, staff, clients, and a witness, all indicated they had never seen S1 conduct themselves in an unprofessional manner with C1. They had never witnessed S1 restrain, strike or handle C1 roughly. S1 denied ever restraining, striking or handling C1 roughly. During C1’s interview, other than complaining facility staff do not know sign language, had no complaints about the facility or S1. C1 denied ever being hit or restrained by S1.

Based on interviews, the allegations that S1 hit C1 on the face, S1 handled C1 roughly, and S1 used restraints on C1 are all deemed UNSUBSTANTIATED at this time.

Exit interview conducted and report issued to licensee administrator.
SUPERVISORS NAME: Jeralyn Ann Pfannenstiel
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE:

DATE: 08/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2