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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565850351
Report Date: 12/26/2023
Date Signed: 12/26/2023 01:10:11 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
11/29/2023 and conducted by Evaluator Esther Cortez
COMPLAINT CONTROL NUMBER: 29-AS-20231129152124
FACILITY NAME:JM'S RESIDENTIAL CARE HOMEFACILITY NUMBER:
565850351
ADMINISTRATOR:OHIDE, JOSEPHFACILITY TYPE:
740
ADDRESS:2221 KEPLER DRTELEPHONE:
(805) 202-9208
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:6CENSUS: DATE:
12/26/2023
UNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Rodolfo Ohide-Administrator TIME COMPLETED:
01:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee falsified documents to obtain a license with CCLD
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Esther Cortez conducted an unannounced subsequent complaint inspection at the facility today to deliver findings regarding the above allegation. The LPA met with staff and explained the reason for the inspection. Administrator Rodolfo O’hide arrived shortly.

On 12/06/2023 the LPA toured the facility, interviewed three (3) residents, interviewed Administrator Rodolfo and collected pertinent documents between 02:35 p.m. and 4:25 p.m. Today, the LPA conducted a file review at 12:05 p.m. and delivered findings.

Report will continue on LIC9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Kasandra LopezTELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Esther CortezTELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:

DATE: 12/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2023
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-20231129152124
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: JM'S RESIDENTIAL CARE HOME
FACILITY NUMBER: 565850351
VISIT DATE: 12/26/2023
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
On the allegation: Licensee falsified documents to obtain a license with CCLD. It was alleged that the licensee falsified documents to obtain control of property. To investigate the allegation, the LPA conducted interviews and conducted a file review. Administrator’s interview and file review revealed that there is a signed residential lease agreement between the Property Owner and Administrator/Licensee leasing the property to the Licensee. The residential lease agreement stated the following: “The agreement shall begin on February 1,2023 and end on January 1,2025. The Tenant shall be allowed to use of property for Home Care Facility (RCFE)." The LPA obtained a copy of the residential lease agreement signed by the Facility Licensees Joseph Ohide (tenant), Rodolfo Ohide (tenant) and Property Owner, dated 2/15/2023. On 12/18/23, the LPA attempted to interview the Property Owner, however they stated they could not speak to the LPA regarding the matter. Based on the information obtained, there is insufficient evidence to substantiate Licensee falsified documents to obtain a license with CCLD. Therefore, the allegation is deemed unsubstantiated at this time.
SUPERVISOR'S NAME: Kasandra LopezTELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Esther CortezTELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:

DATE: 12/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/26/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2