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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565850066
Report Date: 07/19/2022
Date Signed: 07/19/2022 04:21:28 PM

Document Has Been Signed on 07/19/2022 04:21 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:MEADOWGLADE, THEFACILITY NUMBER:
565850066
ADMINISTRATOR:JOAN CARTWRIGHTFACILITY TYPE:
735
ADDRESS:6446 MEADOWGLADE DRTELEPHONE:
(805) 530-5301
CITY:MOORPARKSTATE: CAZIP CODE:
93021
CAPACITY: 6CENSUS: 3DATE:
07/19/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Roxana EsquivelTIME COMPLETED:
04:20 PM
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Licensing Program Analyst (LPA) JoAnn Rosales conducted a Case Management visit to issue final findings related to the Case Management visit conducted on 02/17/2022. LPA met with Administrator Roxana Esquivel.

On 02/17/2022, from 11:00am to 3:48pm, LPA JoAnn Rosales conducted an unannounced Case Management - Incident visit at the facility. LPA Rosales met with Program Director Roxana Esquivel. During the visit, the LPA toured facility with Program Director, reviewed records and obtained pertinent copies of facility records pertaining to a self-reported incident of sexual abuse involving Client #1 (C1) that was reported to Community Care Licensing (CCL) on 2/16/2022. Program Director stated that S1 was terminated on 2/11/2022. LPA explained further investigation was needed regarding the alleged sexual abuse. A referral was made to Community Care Licensing Division's (CCLD) Investigation Branch (IB) and assigned to Investigator Dennis Douglas.

On 03/14/2022, at approximately 1:00pm, Investigator Douglas attempted to interview Program Director Roxana Esquivel, and left message. At approximately 2:00pm, Investigator Douglas contacted the Moorpark Police Department to inquire if an incident report was on file and if there was an open investigation. Investigator Douglas was advised there was no incident report on file. Investigator Douglas conducted interviews with Staff #2 (S2) at approximately 2:30pm; on 03/17/2022, at approximately 10:00am, with Program Director; on 03/24/2022, at approximately 12:30pm, with Clinic Director, C1, and Client #2 (C2); on 05/05/2022, at approximately 10:45am, attempted to contact S1; on 05/17/2022, from approximately 4:16pm to 4:30pm, with Program Director and attempted to contact former client/roommate of C1; on 05/19/2022, from approximately 11:20am to 12:32pm, with Program Director and S1; and on 05/27/2022, from approximately 1:15pm to 3:18pm, with S1 and Program Director. In addition, Investigator Douglas reviewed facility file

Continued on 809C
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Joann Rosales
LICENSING EVALUATOR SIGNATURE: DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/19/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: MEADOWGLADE, THE
FACILITY NUMBER: 565850066
VISIT DATE: 07/19/2022
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documents related to C1.

During the course of the investigation, it was disclosed that C1 disclosed to two roommates and therapist that C1 was having a consensual sexual relationship with S1. While it was acknowledged that no sexual interaction between C1 and S1 was actually witnessed or reported to or by facility staff, it was reported that C1 and S1 were observed in a bathroom together behind a closed door. Both C1 and S1 explained that, in that incident, C1 was having an emotional breakdown in the bathroom and was attempting to harm themself. S1 merely came into the bathroom to assist C1. C1 admitted to being attracted to S1, but during the investigation admitted to Investigator Douglas that C1 made up the claim that C1 was having a sexual relationship with S1 because C1 was embarrassed that S1 would decline C1’s advances. S1 also denied C1’s initial claim of a sexual relationship. Therefore, the allegation of sexual abuse is deemed Unsubstantiated at this time.

Exit interview conducted, a copy of this report was emailed to the Administrator.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Joann Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022
LIC809 (FAS) - (06/04)
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