Complaint Investigation Report

547206290-4-21-2026-24-AS-AWAN-DUFTAE-20260526143323

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

This is an official report of an unannounced visit/investigation of a complaint received in our office on

11/25/2025 and conducted by Evaluator Les Xiong

COMPLAINT CONTROL NUMBER: 24-AS-20251125124025

On 4/21/26, Licensing Program Analyst (LPA) L. Xiong arrived unannounced to deliver findings on the above allegation. LPA met with Administrator, Savanna Chambers.

Interviews revealed that that S1 was terminated on 11/19/2025 due to abuse. It was reported that R1 attempted to elope and S1 pulled R1’s backpack causing R1 to lose balance and fall to the ground.

Based on interviews, the preponderance of evidence standard has been met, therefore the allegation: Resident in care was physically abused is found to be SUBSTANTIATED.

A deficiency is being cited in accordance with California Code of Regulations, Title 22, Division 6 on the attached 9099D. An immediate civil penalty in the amount of $500 is being assessed on the attached LIC421IM

Exit interview conducted and a plan of correction was reviewed and developed with Savanna Chambers. A copy of the report and appeal rights were provided.