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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 330902381
Report Date: 09/29/2020
Date Signed: 09/29/2020 05:54:36 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 600
RIVERSIDE, CA 92501
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/20/2020 and conducted by Evaluator Jazmond D Harris
PUBLIC
COMPLAINT CONTROL NUMBER: 19-CR-20200320124419
FACILITY NAME:CHILDHELP MERV GRIFFIN VILLAGEFACILITY NUMBER:
330902381
ADMINISTRATOR:CORREA, DIANAFACILITY TYPE:
733
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:84CENSUS: 70DATE:
09/29/2020
UNANNOUNCEDTIME BEGAN:
04:12 PM
MET WITH:Assistant Director-Manny BarraganTIME COMPLETED:
04:55 PM
ALLEGATION(S):
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Staff inappropriately touched minor.
INVESTIGATION FINDINGS:
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On September 29, 2020, Licensing Program Analyst (LPA), Jazmond Harris met with Manuel Barragan to issue the investigative findings for the allegation. The investigation was initiated by LPA Kim Robinson on March 16, 2020 at 3:10 PM. No immediate safety hazards were noted. During the investigation, LPA Harris conducted interviews with Child Care Worker, Client #1 (See Confidential Names List (LIC 811) dated September 23), and County Social Worker, Julie Agape Mendoza.

On March 20, 2020, Community Care Licensing received information which stated Staff inappropriately touched minor. It was reported that Child Care Worker rubbed his body up against Client #1's during a restraint. Child Care Worker admitting to providing care and supervision to Client #1. Child Care Worker denied the allegation and stated he never touched Client #1. Child Care Worker could not provide specific details regarding the incident. Child Care Worker could not recall if he had to restrain Client #1 at any time. Client #1 admitted to providing a falsified the statement regarding the Child Care Worker rubbing his body up against Client #1's body during a restraint. Client #1 stated that Child Care Worker only "grabbed"
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: LaCresha CookTELEPHONE: (951) 782-4137
LICENSING EVALUATOR NAME: Jazmond D HarrisTELEPHONE: (951) 847-6491
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2020
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 19-CR-20200320124419
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 3737 MAIN ST., SUITE 600
RIVERSIDE, CA 92501
FACILITY NAME: CHILDHELP MERV GRIFFIN VILLAGE
FACILITY NUMBER: 330902381
VISIT DATE: 09/29/2020
NARRATIVE
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Client #1, but did not touch Client #1 inappropriately. Client #1 reported making the false claims in order to be transferred to a different facility. County Social Worker stated Client #1 has a history of making false claims and Client #1 admitted to County Social Worker that the claim against Child Care Worker was fabricated. County Social Worker stated the information she obtained revealed that the alleged inappropriate interaction between Client #1 and Child Care Worker did not corroborate with Child Care Workers demeanor. County Social Worker stated she had no concerns.

Based on interviews and information obtained, the Child Care Worker inappropriately touched Client #1, may have occurred; however, is not supported or proven by evidence. Therefore, the allegation is unsubstantiated at this time.

An exit interview was conducted, appeal rights explained, and a copy of this report will be provided. The signature of the representative is on file.
SUPERVISOR'S NAME: LaCresha CookTELEPHONE: (951) 782-4137
LICENSING EVALUATOR NAME: Jazmond D HarrisTELEPHONE: (951) 847-6491
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2