567609712-8-3-2026-29-AS-DPEA-DXCQRA-20260827122336

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 567609712
Report Date: 08/03/2026
Date Signed: 08/03/2026 04:25:19 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
07/31/2026 and conducted by Evaluator Brian Balisi

COMPLAINT CONTROL NUMBER: 29-AS-20260731114430

FACILITY NAME:	BERNADETTE HOME CARE II		FACILITY NUMBER:	567609712
ADMINISTRATOR:	ABIERA, BERNADETTE		FACILITY TYPE:	740
ADDRESS:	1982 LATHAN AVE		TELEPHONE:	(805) 437-6302
CITY:	CAMARILLO	STATE: CA	ZIP CODE:	93010
CAPACITY:	6	CENSUS: 6	DATE:	08/03/2026
		UNANNOUNCED	TIME BEGAN:	01:00 AM
MET WITH:	Willy Lucido		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff do not provide adequate food service

Staff do not safeguard resident's personal belongings

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced complaint visit to investigate the allegations listed above. Upon arrival LPA met with staff and explaind the reason for the visit. Administrator arrived shortly after.

At approx 12:55 p.m. LPA conducted physical plant, interviewed staff, residents and reviewed and obtained copies of pertinent documentation relevant to the investigation.
It was reported that "staff do not provide adequate food service" as It was alleged that the facility frequently provides Resident #1 (R1) with food that is not appropriate for a diabetic diet. LPA interviewed two of five residents who stated they had no concerns with the quality, variety, or taste of the food provided. One resident stated they liked the food and its variety but preferred to obtain food from outside the facility. LPA was unable to effectively interview the remaining three residents. LPA also interviewed R1's family/responsible party, who reported no concerns regarding the food provided to R1 or the other residents.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2026

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-20260731114430

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: BERNADETTE HOME CARE II	FACILITY NUMBER: 567609712
	VISIT DATE: 08/03/2026

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

Continued from 9099

During the physical plant inspection, LPA observed an adequate supply of perishable and nonperishable food, including lean proteins, fresh vegetables, whole grains, and fresh fruit, properly stored and available to meet residents' dietary needs. 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 allegations "Staff do not provide adequate food service" has been deemed Unsubstantiated at this time.

It was reported that "Staff do not safeguard resident's personal belongings" as It was alleged that staff took R1's blood glucose monitor and refused to return it. Interviews and record review determined that the facility centrally stored the blood glucose monitor for R1. Staff reported that the sensor routinely replaced every 10 days. On the scheduled replacement date, R1 refused to wear the device. LPA confirmed that R1 did not have a physician's order or prescription for the blood glucose monitor. LPA's interview with R1 reflected that they did not want to wear the device. When LPA asked whether they wanted staff to return the device, R1 declined. LPA's interview with two (2) other residents in care reflected that they had no concerns with staff taking away their personal belongings. LPA also interviewed R1's family/responsible party, who reported no concerns regarding staff taking away residents personal belongings. 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 allegations "Staff do not safeguard resident's personal belongings" has been deemed Unsubstantiated at this time.

During the visit, the Administrator informed LPA that they needed to leave the facility due to a prior appointment. The Administrator stated that available facility staff were authorized to sign documents on their behalf.

Exit interview conducted and copy of report issued.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Brian Balisi
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 2