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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565802405
Report Date: 08/29/2024
Date Signed: 08/29/2024 04:51:47 PM

Document Has Been Signed on 08/29/2024 04:51 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME:SAILS 50/50FACILITY NUMBER:
565802405
ADMINISTRATOR/
DIRECTOR:		ROOS, MARCHELINOFACILITY TYPE:
735
ADDRESS:1071 BALSAMO AVETELEPHONE:
(760) 631-7550
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93065
CAPACITY: 4CENSUS: 4DATE:
08/29/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:30 PM
MET WITH:Marchelino RoosTIME VISIT/
INSPECTION COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced Case Management – Incident visit at 3:30 p.m. for the purpose of investigating self-reported incident reports.  LPA was joined by Tri-Counties Regional Center (TCRC) Quality Assurance Specialist (QAS) Ryan Landseadel and Patrick Brown. Upon arrival, LPA and QAS met with Program Director Marchelino Roos and explained the reason for the visit. On August 12, 2024, at approximately 5:15 PM, Client #1 (C1)  became upset after being advise over coffee consumption, which resulted In C1 eloping from the home.SAILS 50/50 DCS immediately followed C1, maintaining a safe distance while keeping C1 in sight. As C1 continued to be verbally aggressive and spoke on the phone, DCS monitored the situation. After a few blocks, DCS successfully redirected C1 and convinced C1 to return home. At approximately 6:20 PM, two law enforcement officers arrived at the home for a welfare check. C1 had alleged that Staff #1 (S1) pushed C1 on Saturday, August 10th. During the visit, the officers requested to speak with S1 who C1 had accused of pushing C1. The officers reviewed the client's records, home schedules, and interviewed the Administrator. They found that S1's allegations were unsubstantiated, as the records clearly showed that DCS was not working on that day. Before the officers departed,C1 began raising their voice toward the Administrator and the officers. One officer intervened, advising C1 to go inside, relax, and take a break to for de-escalate.

At approx 3:35pm, LPA conducted physical plant, interviewed staff, clients and reviewed and obtained copies of pertinent documentation relevant to the investigation. Records review revealed S1 was not on the schedule on August 10. LPA and QAS interviews with four (4) staff and Client #1 (C1)  revealed they all have not observed any staff become physically or verbally aggressive with any clients in care. Each person interviewed did not express any immediate or potential concerns for staff becoming physically or verbally aggressive with them at this time. Based on interviews and records review no immediate or potential  health and safety concerns were observed during the visit and no deficiencies cited at this time.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE: DATE: 08/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/29/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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