565802410-4-17-2025-29-AS-KBUY-DG7MCP-20250429092951

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565802410
Report Date: 04/17/2025
Date Signed: 04/17/2025 01:51:19 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
10/15/2024 and conducted by Evaluator Brian Balisi

COMPLAINT CONTROL NUMBER: 29-AS-20241015160709

FACILITY NAME:	PEOPLE'S CARE GOODENOUGH		FACILITY NUMBER:	565802410
ADMINISTRATOR:	DANIELA MOSQUERA		FACILITY TYPE:	735
ADDRESS:	2591 GOODENOUGH RD		TELEPHONE:	(805) 524-5617
CITY:	FILLMORE	STATE: CA	ZIP CODE:	93015
CAPACITY:	6	CENSUS: 5	DATE:	04/17/2025
		UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Rudi Otani - House Manager		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Sexual Abuse: Resident #1 (R1) was sexually abused by facility Staff #1 (S1) while in care.

Staff are using profanity in the presence of a resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Brian Balisi conducted a subsequent complaint visit to deliver final findings for the above allegation. During today’s visit, LPA met with House Manager Rudi Otani and explained the reason for the visit.

On 10/15/2024, the Woodland Hills North Adult and Senior Care Regional Office (RO) received a complaint alleging Resident #1 (R1) was sexually abused by facility Staff #1 (S1). The complaint was referred to the Community Care Licensing Division (CCLD) Investigations Branch (IB) and assigned to Investigator Johnny Canto.

On 10/17/2024, from 10:30am to 12:00pm, Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced complaint visit. At approximately 10:42am, LPA Balisi conducted a physical plant tour, interviewed staff, and reviewed and obtained copies of pertinent documentation relevant to the investigation. The LPA determined further investigation was required.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2025

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-20241015160709

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: PEOPLE'S CARE GOODENOUGH	FACILITY NUMBER: 565802410
	VISIT DATE: 04/17/2025

NARRATIVE

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Investigator Canto conducted interviews with the administrator, R1, residents, staff and S1.
In addition, the investigator reviewed Ventura County Sheriff’s Department (VCSD) Report #2024-130212 and facility file documents pertinent to the investigation.

On 03/13/2025, LPA Teri Camara interviewed two (2) residents during a collateral visit at PALS Skill Center and also interviewed two (2) residents at the home during a follow-up visit for a separate investigation.

A review of R1’s Physician Report dated 06/04/2024 lists the primary diagnosis as Autism and secondary diagnosis as intellectual impairment. Further review of R1’s records included behavior report, Individual Service Plan (ISP) and Individual Program Plan (IPP) revealed R1 was admitted to the facility on 06/08/2017 and was able to communicate wants and needs to others effectively and verbally. R1 has a history of aggression, theft, property destruction, graffiti, and elopement.

According to the information in the SOC341 form “Report of Suspected Dependent Adult/Elder Abuse” R1 reported that R1 was watching porn in the backyard on a tablet and was redirected to R1’s bedroom by R1’s housemate and staff. R1 reported that once in R1’s bedroom, S1 entered the bedroom, closed the blinds, and masturbated R1. R1 reported that R1 told S1 to stop, however S1 did not. R1 reported that R1 informed the home supervisor the following day of the incident, however, there was no evidence found that the home supervisor was notified of any incident.

The facility logbook was reviewed. As of 10/13/2024 S1’s log entry stated R1 was watching the football game, R1 was smoking outside, R1 ate dinner, R1 was on the phone with friends, R1 took meds and went to the room to relax. There was no indication of any behavioral episodes or redirection needed for R1 on that date.

During the course of the Department’s investigation, interviews were conducted with R1, the facility staff, and the alleged suspect S1. The Ventura County Sheriff's Department responded to the allegation and conducted their investigation. Their investigation noted no criminal prosecution. R1 alleged S1 sexually battered R1, specifically, R1 alleged S1 masturbated R1. R1 gave several inconsistent statements regarding the alleged incident; however, R1 maintained the allegation. R1 was unable to provide specific information regarding the allegation. S1 denied the allegation and theorized the allegation was made due to R1’s behavior of not following house rules.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2025

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20241015160709

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: PEOPLE'S CARE GOODENOUGH	FACILITY NUMBER: 565802410
	VISIT DATE: 04/17/2025

NARRATIVE

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The facility director and facility staff stated R1 has a history of masturbating in public areas along with a history of fabrication when R1’s wants and needs are not met. The Department found no evidence to determine the allegation as true. Therefore, the allegation “Sexual Abuse: Resident #1 (R1) was sexually abused by facility Staff #1 (S1) while in care” is deemed Unsubstantiated at this time.

It was reported that "Staff are using profanity in the presence of a resident" as it was alleged that residents can hear staff using profanity. Interviews with four (4) residents indicated that none of them have ever heard staff use profanity or any inappropriate language. Additionally, interviews with three (3) staff members revealed that none of them have ever heard staff use profanity or inappropriate language in the presence of clients in care. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation, “Staff are using profanity in the presence of a resident” is deemed Unsubstantiated at this time.

Exit interview conducted, copy of this report issued.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2025

LIC9099 (FAS) - (06/04)

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