Senior Care Records.

Facility Evaluation Report

Momentum Work, INC. Lakeside, Santa Maria01/12/2026Licence 425850008

Capacity4
Census4
Date signed01/12/2026 02:41:05 PM
Name of licensing program analystMark Jeffries
Name of licensing program managerKelly Burley
The inspector’s account

At 12:00pm on 01/12/2026 Licensing Program Analyst (LPA) Jeffries arrived to the facility unannounced to conduct a case management visit pertaining to the incident that took place 01/06/2026 with staff (S1) alleged physical abuse of client (C1) in care. LPA Jeffries conducted interviews with facility Administrator, and Staff (S2) who reported incident. LPA conducted observation and video of room and door functions of room in the room alleged abuse took place. LPA noted that the S1 is primarily scheduled at the day program and was schedule from the facilities day program and not the facility home on 01/06/2026. Normal work conditions have day program staff work with client at facility home if client chooses to come back to the facility home during day program hours. LPA requested a copy of internal report of incident investigation by facility, C1, behavior intervention plan, C1 appraisals needs and assessment, and staff schedules for all staff working in the facility on 01/06/2026, as well contact phone numbers for all persons working on 01/06/2026. LPA requested S1 training for last 12 months. LPA will need to conduct additional interviews.

Exit interview, report read, and report provided.

Source: California Department of Social Services, Community Care Licensing. Methodology · Report a correction