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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 567609834
Report Date: 12/16/2024
Date Signed: 12/16/2024 03:22:31 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
08/06/2024 and conducted by Evaluator Martha Arroyo
COMPLAINT CONTROL NUMBER: 29-AS-20240806115517
FACILITY NAME:BCBN LLC EFACILITY NUMBER:
567609834
ADMINISTRATOR:FARRUGGIA, FABIANAFACILITY TYPE:
735
ADDRESS:2244 GLORYETTE AVETELEPHONE:
(805) 285-0294
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93063
CAPACITY:4CENSUS: 4DATE:
12/16/2024
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Florencia FarriggiaTIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff interfered with resident's medical procedure.
Staff is forcing residents to attend community programs.
Staff did not report incident.
Staff denied resident access to food.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA), Martha Arroyo conducted a subsequent complaint visit to the above facility. The purpose of the visit is to deliver findings for the above allegations. LPA M. Arroyo along with Tri-Counties Regional Center Quality Assurance Specialist (QAS) Ryan Landseadel conducted an initial complaint visit on 08/13/2024 and a subsequent visit on 08/27/2024. On today's visit, LPA Arroyo met with Administrator, Florencia Farruggia. Entrance interview.

During the initial visit on 08/13/2024, LPA and QAS conducted interviews with the Administrator and one resident between 1:43PM and 3:55PM, conducted a file review at 2:30PM, and obtained copies of pertinent documents. On 08/27/2024, LPA and QAS conducted an interview with the Administrator at 3:50PM, conducted a file review at 3:05PM, and obtained copies of pertinent documents. On 09/30/2024, LPA Arroyo and QAS conducted a collateral visit at Arc VC-Cochran and conducted interviews with two (2) clients between 9:25AM and 10:10AM.
Report continued on LIC 9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
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 6
Control Number 29-AS-20240806115517
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: BCBN LLC E
FACILITY NUMBER: 567609834
VISIT DATE: 12/16/2024
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
Report Continued from LIC 9099...

It was alleged that staff interfered with resident’s medical procedure. It was reported that facility staff prohibited resident from conducting their colonoscopy preparation in the home. Record reviews and interviews conducted revealed that Resident #1 (R1) had a colonoscopy scheduled for the second week of April 2024. Resident notes dated 04/13/2024 indicated that R1 had informed facility staff that the procedure was stopped because the medication needed for preparation was not effective. Additionally, R1 was staying with a family member during the preparation period from 04/08/2024 to 04/13/2024, so the facility staff was unable to assist or intervene with the procedure preparation. Furthermore, R1 successfully completed the colonoscopy procedure on 07/02/2024 after facility staff helped R1 prepare by ensuring they consumed the correct foods. Based on the information obtained and reviewed, the Department has insufficient evidence to support the allegation of “staff interfered with resident’s medical procedure”. Therefore, this allegation is deemed Unsubstantiated at this time.

It was also alleged that staff is forcing residents to attend community programs. It was reported that residents did not get to choose the day program to attend and are being sent out of the home into the community. Records review of R1's notes, dated 03/04/2024, revealed that R1 did not attend the day program on that day. However, R1 had planned an outing to spend time with their friend and have fun. Interviews with staff indicated that the facility encourages residents to engage in community activities and supports all outings the residents choose to participate in. Staff stated that, on many occasions, residents may refuse to go out into the community or participate in outings. However, they are never forced to participate, as residents have the right to choose their activities. Additionally, staff added that residents choose to have outings every weekend, providing them the opportunity to spend time together. Further interviews with residents revealed that they enjoy attending their current day program, noting that it offers more activities than the previous one. Based on interviews conducted with facility staff and residents, the Department has insufficient evidence to support the allegation of “staff is forcing residents to attend community programs”. Therefore, this allegation deemed Unsubstantiated at this time.

Report Continued on LIC 9099C...

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 29-AS-20240806115517
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: BCBN LLC E
FACILITY NUMBER: 567609834
VISIT DATE: 12/16/2024
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
Report Continued from LIC 9099C...

It was also alleged that staff did not report incident. It was reported that facility staff did not report an incident regarding over-the-counter drugs being found in resident’s room. Record review of incident reports submitted to the Department by the facility revealed that staff was actively documenting all incidents regarding R1 in accordance with the Department’s policies and regulations. On 05/04/2024, an incident report was submitted stating that R1 had returned from staying with family for five (5) days and was missing medication. However, R1 was unable to confirm whether they had taken the medication or missed the dose. Additionally, in July 2024, the Department received four (4) incident reports pertaining to R1. One of these reports, dated 07/17/2024, indicated that facility staff had found an empty wrapper for Rolaids near R1. Interviews with staff revealed that R1 was often reminded to communicate with facility staff about any medications prescribed to them that staff was not aware of. Furthermore, facility staff has been reporting all reportable incidents to the Department. Based on the information obtained and reviewed, the Department has insufficient evidence to support the allegation of “staff did not report incident”. Therefore, this allegation is deemed Unsubstantiated at this time.

It was further alleged that staff denied resident access to food. It was reported that resident was denied access to food on 08/04/2024. During the initial visit on 08/13/2024, LPA and QAS observed sensors on the pantry cabinets and refrigerator. Upon opening the pantry doors and refrigerator, an auditory alarm sounded. Interviews conducted with staff revealed that the sensors were installed solely as a means to notify staff when someone is in the kitchen. However, staff denied placing the sensors to withhold or deny food or snacks to the residents. Staff added that residents are encouraged to make healthier snack choices when they come to the kitchen. Interviews with residents revealed that the facility provides meals and snacks to all residents. Furthermore, during interviews, residents did not report any concerns about staff denying them food at any time while living at the facility. Based on the information obtained and reviewed, the Department has insufficient evidence to support the allegation of “staff denied resident access to food”. Therefore, this allegation is deemed Unsubstantiated at this time.

Exit interview conducted. Report was reviewed and copy issued.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 6
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
08/06/2024 and conducted by Evaluator Martha Arroyo
COMPLAINT CONTROL NUMBER: 29-AS-20240806115517

FACILITY NAME:BCBN LLC EFACILITY NUMBER:
567609834
ADMINISTRATOR:FARRUGGIA, FABIANAFACILITY TYPE:
735
ADDRESS:2244 GLORYETTE AVETELEPHONE:
(805) 285-0294
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93063
CAPACITY:4CENSUS: 4DATE:
12/16/2024
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Florencia FarriggiaTIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff are violating resident’s personal rights.
Staff did not give resident access to warm water.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA), Martha Arroyo conducted a subsequent complaint visit to the above facility. The purpose of the visit is to deliver findings for the above allegations. LPA M. Arroyo along with Tri-Counties Regional Center Quality Assurance Specialist (QAS) Ryan Landseadel conducted an initial complaint visit on 08/13/2024 and a subsequent visit on 08/27/2024. On today's visit, LPA Arroyo met with Administrator, Florencia Farruggia. Entrance interview.

During the initial visit on 08/13/2024, LPA and QAS conducted interviews with the Administrator and one resident between 1:43PM and 3:55PM, conducted a file review at 2:30PM, and obtained copies of pertinent documents. On 08/27/2024, LPA and QAS conducted an interview with the Administrator at 3:50PM, conducted a file review at 3:05PM, and obtained copies of pertinent documents. On 09/30/2024, LPA Arroyo and QAS conducted a collateral visit at Arc VC-Cochran and conducted interviews with two (2) clients between 9:25AM and 10:10AM.
Report Continued on LIC 9099C...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 29-AS-20240806115517
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: BCBN LLC E
FACILITY NUMBER: 567609834
VISIT DATE: 12/16/2024
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
Report Continued from LIC 9099C...
It was alleged that facility staff are violating resident’s personal rights. It was reported that facility staff is demonstrating hostility towards R1 in the form of verbal aggression, discussing the resident’s eviction notice in front of other residents, and threatening to contact law enforcement if R1 does not find an alternative place to live. During interviews with the Administrator, they stated that they had explained the court proceedings to R1 and denied threatening to call law enforcement or discussing the eviction notice with R1. However, during interviews with residents, it was revealed that other residents were aware of R1's eviction notice. Further interviews revealed that residents had overheard the Administrator telling R1 that they needed to find a new home, as the facility could no longer meet their needs. Additionally, residents reported that the Administrator would communicate with other residents regarding R1's move out of the facility. Furthermore, residents stated that R1 would argue and bully other residents, and although the Administrator's intention was to defend the other residents from being bullied by R1, residents reported that the Administrator did, at one point, raise their voice at R1 while defending them. Based on interviews conducted with facility staff and residents, the Department has sufficient evidence to support the allegation of “facility staff are violating resident’s personal rights”. Therefore, this allegation is deemed Substantiated at this time.

It was also alleged that staff did not give resident access to warm water. It was reported that resident did not have hot water accessible to them in their bathroom sink. During the initial visit on 08/13/2024, LPA and QAS measured the water temperature at two (2) resident bathroom sinks and the kitchen sink. The first bathroom, located near R1’s bedroom and the common area, measured 91.7 degrees Fahrenheit at 1:30 PM. The second bathroom, located near the main hallway, measured 96.8 degrees Fahrenheit at 1:36 PM. The kitchen faucet measured 97.7 degrees Fahrenheit at 1:39 PM. Although warm water is accessible to residents and no concerns were expressed during interviews about the water temperature, the measured temperatures did not meet the required range of 105 to 120 degrees Fahrenheit, as per regulation. Based on LPA observation, the Department has sufficient evidence to support the allegation of “staff did not give resident access to warm water”. Therefore, this allegation is deemed Substantiated at this time.

The following deficiencies were observed (See LIC 809-D.) and cited from the California Code of Regulations, Title 22 and California Health and Safety Code. Failure to correct the deficiencies may result in civil penalties.

Exit interview conducted. A copy of the report and appeal rights were provided.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 29-AS-20240806115517
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: BCBN LLC E
FACILITY NUMBER: 567609834
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/16/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/20/2024
Section Cited
CCR
80072(a)(1)(3)
1
2
3
4
5
6
7
Each client shall have personal rights which include... to be accorded dignity in his/her personal relationships with staff and other persons. To be free from… humiliation, intimidation, ridicule, coercion, threat, mental abuse. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
The Administrator will review regulation 80072 Personal Rights and submit a statement of understanding to CCL no later than POC due date.
8
9
10
11
12
13
14
Based on interviews, the licensee did not comply with the section cited above as R1’s eviction notice was discussed in common areas for other residents to hear, which posed a potential personal rights risk to persons in care.
8
9
10
11
12
13
14
Type B
12/16/2024
Section Cited
CCR
80088(e)(1)
1
2
3
4
5
6
7
Faucets used by clients for personal care such as shaving and grooming shall deliver hot water. Hot water temperature controls shall be maintained to automatically regulate temperature of hot water delivered to plumbing fixtures used by clients to attain a hot water temperature of not less than 105 degrees F (40.5 degrees C) and not more than 120 degrees F (48.8 degrees C). This requirement was not met as evidenced by:
1
2
3
4
5
6
7
The Administrator had water heater replaced and water temperature is now within the range of 105 and 120 degrees Fahrenheit.

POC has been met.
8
9
10
11
12
13
14
Based on LPA observation, the licensee did not comply with the section cited above as two (2) out of two (2) facility restroom faucets delivered hot water measured at 91.7 and 96.8 degrees Fahrenheit, which posed a potential health and safety risk to persons in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2024
LIC9099 (FAS) - (06/04)
Page: 6 of 6