565802000-9-30-2026-29-AS-KLOZ-DYF29P-20260930171217

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565802000
Report Date: 09/30/2026
Date Signed: 09/30/2026 03:01:25 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 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
10/13/2025 and conducted by Evaluator Esther Cortez

COMPLAINT CONTROL NUMBER: 29-AS-20251013182358

FACILITY NAME:	DREAM HAVEN OF SANTA PAULA		FACILITY NUMBER:	565802000
ADMINISTRATOR:	GRACE CATABAY		FACILITY TYPE:	740
ADDRESS:	404 E. MAIN STREET		TELEPHONE:	(805) 420-9605
CITY:	SANTA PAULA	STATE: CA	ZIP CODE:	93060
CAPACITY:	0	CENSUS: 0	DATE:	09/30/2026
		UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Grace Catabay		TIME COMPLETED:	02:40 PM

ALLEGATION(S):

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Staff are mismanaging resident's medications.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Esther Cortez issued final findings to former Licensee Representative Grace Catabay for this investigation via US mail and email. The facility closed effective 02/03/2026.

On 10/17/25, the LPA toured the facility with the Designee, reviewed resident 1 (R1's) PRN medication, and interviewed three (3) staff. The LPA attempted to review staff files however files were not available at the facility and arrived until 4:11 p.m. On 10/20/25, the LPA interviewed two (2) staff, two (2) witnesses, one (1) resident, conducted a file review and collected pertinent documents relevant to the investigation. During today's visit the LPA conducted a file review. On 03/02/206, the LPA conducted a collateral visit at Caring Hearts of Santa Paula and conducted a file review and obtained copies of records relevant to the investigation.

Report will continue on LIC9099-C, 2nd page.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2026

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20251013182358

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: DREAM HAVEN OF SANTA PAULA	FACILITY NUMBER: 565802000
	VISIT DATE: 09/30/2026

NARRATIVE

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Regarding the allegation, “Staff are mismanaging resident's medications” it is the concern of the Reporting Party (RP) that facility staff appeared to not understand PRN medications. It was further reported that when a witness requested administration of PRN Seroquel, staff seemed confused about the medication and when to give it. During an interview, the staff (S1) that was on shift when the witness was present denied being confused about the resident’s medication and denied telling the witness they were confused. S1 revealed that staff assist R1 with their PRN only as needed when R1 is agitated as indicated in the instructions. S1 was able to state what agitation looked like for R1, stated that they followed the medication instruction, knew the difference between daily and PRN medication and if they were confused about any medication they would ask the Designee. An interview with the Designee and a review of the records revealed that R1 had been really agitated between 10/07/25 and 10/09/25, and staff was administering the medication every four hours as indicated in R1’s Quetiapine Fumarate (Seroquel) PRN log. Although the allegation may have happened or is valid, there is not sufficient evidence to prove the alleged violation did or did not occur, therefore the allegations is deemed Unsubstantiated at this time.

A copy of this report and appeal rights issued via mail and email.

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2026

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2026

LIC9099 (FAS) - (06/04)

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