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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565802463
Report Date: 12/13/2023
Date Signed: 12/13/2023 02:02:41 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 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
12/04/2023 and conducted by Evaluator Teresa Camara
PUBLIC
COMPLAINT CONTROL NUMBER: 29-AS-20231204105536
FACILITY NAME:PEOPLE'S CARE HOWEFACILITY NUMBER:
565802463
ADMINISTRATOR:DANSHELLE DAYFACILITY TYPE:
735
ADDRESS:3851 HOWE RDTELEPHONE:
(805) 398-5096
CITY:FILLMORESTATE: CAZIP CODE:
93015
CAPACITY:6CENSUS: 4DATE:
12/13/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Danshelle DayTIME COMPLETED:
02:25 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff hit resident in care
Staff pushed resident in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Teresa Camara conducted an initial complaint investigation visit regarding the above noted allegations. LPA was joined by Tri-Counties Regional Center (TCRC) Quality Assurance Specialist (QA) Liz Aced-Arnett. LPA and QAS met with Administrator Danshelle Day and explained the reason for the visit.

Interviews were conducted with staff at 10:19 a.m. 10:27 a.m. and 11:11 a.m. Client 1 (C1) was interviewed at 11:02 a.m. During the interview with C1, it was revealed C1 alleged staff pushed and hit them because C1 was mad and wanted to "get away for a while." C1 stated they are doing better at the facility now. During interviews with staff, nobody has witnessed any abuse by staff or other clients at the facility.

Based on the interview with C1 where C1 recanted allegations of abuse, the allegations staff hit and pushed the client are deemed UNSUBSTANTIATED at this time. Exit interview conducted and copy of report issued to the Administrator.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2023
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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