565850429-11-24-2025-29-AS-DPEA-DNT22X-20251126160129

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565850429
Report Date: 11/20/2025
Date Signed: 11/24/2025 12:53:52 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
08/27/2025 and conducted by Evaluator Zabel Chochian

COMPLAINT CONTROL NUMBER: 29-AS-20250827144423

FACILITY NAME:	MOMENTUM AGENCIES CREATIVE ARTS CENTER NORTH		FACILITY NUMBER:	565850429
ADMINISTRATOR:	ANDERSON, LORI		FACILITY TYPE:	775
ADDRESS:	2400 WILLOW LANE		TELEPHONE:	(818) 782-2211
CITY:	THOUSAND OAKS	STATE: CA	ZIP CODE:	91361
CAPACITY:	100	CENSUS: 51	DATE:	11/20/2025
		UNANNOUNCED	TIME BEGAN:	09:36 AM
MET WITH:	John Lynch, Senior Director		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Licensee does not ensure that staff are adequately trained.
Staff do not adequately supervise clients in care.
Licensee does not adhere to staff-client ratio requirements.
Licensee does not ensure that facility food is stored in a safe manner.
Licensee does not ensure that hazardous chemicals are inaccessible to clients in care.
Licensee is not ensuring that clients information is kept confidential.
Staff did not maintain a comfortable temperature for clients in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Zabel Chochian conducted a subsequent complaint visit to conclude the investigation and deliver final findings for the above allegations. During today’s visit, LPA met with John Lynch, Senior Director (SD) and explained the reason for the visit.

On 08/27/2025, the Department received a complaint regarding the above allegations,
During the initial complaint visit on 9/05/2025, LPA and SD toured the physical plant areas inside and outside to ensure there are no immediate health and safety hazards and facility is in compliance with Title 22 Regulations. Allegations were discussed and copies of pertinent records relevant to the investigation was requested.

To investigate the complaint allegations, LPA reviewed a random sample of staff training records; facility staff schedules; interviewed seven (7) clients and five (5) staff.
(Continue to LIC9099c)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2025

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-20250827144423

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: MOMENTUM AGENCIES CREATIVE ARTS CENTER NORTH	FACILITY NUMBER: 565850429
	VISIT DATE: 11/20/2025

NARRATIVE

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Regarding allegation, Licensee does not ensure that staff are adequately trained: Information was received that staff lack training in de-escalation techniques. LPA reviewed a total of five (5) staff files and conducted interviews with staff. Records reviewed and interviews conducted revealed that staff complete training prior to hiring and are provided with ongoing training annually. SD explained that the corporate has a tracking system for staff training; training is through Relias; staff due for training complete the required training on a flow basis. Staff interviewed confirmed receiving training in challenging behaviors, de-escalation techniques and other support techniques upon hire and annually. 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 “Licensee does not ensure that staff are adequately trained” is deemed Unsubstantiated at this time.

Regarding allegations, Staff do not adequately supervise clients in care and Licensee does not adhere to staff-client ratio requirements. Information was received that clients are often unsupervised; clients regularly eat without staff supervision, posing a choking hazard. Additional information provided was that the program is critically understaffed; Lead Instructors / LVNs inappropriately counted toward the staff-to-client ratio. Investigation consist of interviews with staff and randomly selected clients. In addition LPA reviewed that facility staffing assignments for 8/2025-9/2025. Interview with staff and randomly selected clients able to communicate revealed that staffing is sufficient and not understaffed. Client expressed being satisfied with the program and staff. LPA reviewed the facility schedules and staffing assignments. Records review revealed there are 30 DSP staff, 2 management staff and 4 nurses; total clients served is 51, with 44 clients on 3:1 client to staff ratio, 7 clients served 1:1 by the program and 2 clients served 1:1 by outside agency. LPA observed the facility to be following their client to staff ratio during unannounced visit conducted by LPA on 08/13/2025, 09/05/2025 and 11/20/2025. Regarding clients regularly eating without supervision, staff denied the allegation and reported that there is always a staff present while clients are eating. Clients interviewed confirmed that there is always staff present.

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 allegations “Staff do not adequately supervise clients in care and Licensee does not adhere to staff-client ratio requirements” is deemed Unsubstantiated at this time. (Continue to LIC9099c)

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2025

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20250827144423

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: MOMENTUM AGENCIES CREATIVE ARTS CENTER NORTH	FACILITY NUMBER: 565850429
	VISIT DATE: 11/20/2025

NARRATIVE

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Regarding allegations, Licensee does not ensure that facility food is stored in a safe manner and Licensee does not ensure that hazardous chemicals are inaccessible to clients in care. Information was received that food is improperly labeled/stored; drinks and snacks are left out and accessible. Additionally, kitchen closet storing chemicals remains unlocked except during lunch. Investigation consist of interviews with staff and physical plant tour on 08/13/2025, 09/05/2025 and 11/20/2025. Staff reported that the clients lunch is stored appropriately; if needed refrigeration clients lunch is refrigerated if not there kept in other appropriate storage. LPA observed clients food labeled and stored appropriately during the unannounced visits. During LPA’s unannounced visits all hazardous items observed locked in the lunchroom storage room and other common locked storage areas in the facility. 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 allegations “Licensee does not ensure that facility food is stored in a safe manner and Licensee does not ensure that hazardous chemicals are inaccessible to clients in care” is deemed Unsubstantiated at this time.

Regarding allegations, Licensee is not ensuring that clients information is kept confidential, and Staff did not maintain a comfortable temperature for clients in care. Information was received that clients served have access to the staff lounge and its contents. Additionally, information was received that the air conditioning is not working properly and that all the rooms and changing bathrooms are hot, with no air circulation.
Investigation consist of interviews with staff and clients; unannounced site visit physical plant tour on 08/13/2025, 09/05/2025 and 11/20/2025. LPA did not observe any client or staff files accessible in the staff lounge area during the unannounced site visits. Physical plant tour conducted during the unannounced visits to the facility revealed no issues or concern with maintaining comfortable room temperatures for clients and staff. Group rooms and changing restrooms temperature was recorded at 71*F during the site visit on 09/05/2025. Clients and staff interviewed reported no issues with room temperatures.
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 allegations “Licensee is not ensuring that clients information is kept confidential, and Staff did not maintain a comfortable temperature for clients in care” is deemed Unsubstantiated at this time.

Exit interview conducted. A copy of the report was provided.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE:	DATE: 11/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2025

LIC9099 (FAS) - (06/04)

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