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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 195850091
Report Date: 11/13/2024
Date Signed: 11/13/2024 03:28:07 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
10/15/2024 and conducted by Evaluator Angela Barutyan
COMPLAINT CONTROL NUMBER: 29-AS-20241015125318
FACILITY NAME:PRESERVE AT WOODLAND HILLS, THEFACILITY NUMBER:
195850091
ADMINISTRATOR:SUSAN WEISBARTHFACILITY TYPE:
740
ADDRESS:6221 FALLBROOK AVENUETELEPHONE:
(747) 226-5834
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91367
CAPACITY:60CENSUS: 35DATE:
11/13/2024
UNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Tony NunezTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Resident was physically abused while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a subsequent complaint investigation for the allegation listed above at 02:45PM. LPA met with Health and Services Director (HSD) Antonio “Tony” Nunez and Executive Director (ED) Susan Weisbarth and explained the reason for the visit.

During today's visit, LPA met with the HSD and ED to deliver final findings for the above allegation. During the initial complaint visit which took place on 10/17/2024, LPA interviewed ED and HSD, reviewed and obtained copies of pertinent documents, conducted a brief physical plant tour with ED at 04:47PM, and interviewed two (2) residents and one (1) visitor between 04:49PM - 05:05PM.
Continued on LIC 9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2024
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 2
Control Number 29-AS-20241015125318
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: PRESERVE AT WOODLAND HILLS, THE
FACILITY NUMBER: 195850091
VISIT DATE: 11/13/2024
NARRATIVE
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It was alleged that a resident was physically abused while in care. The complainant alleged that on 10/08/2024, Resident #1 (R1) was observed to be in distress and crying while pointing to their bathroom and saying, “they beat me.” The LPA interviewed the complainant who stated that the allegation was “more a hunch than proof that was the case, [R1] simply may have been a little tired from exercising” and stated that R1 has difficulty expressing words due to history of Aphasia. The complainant also stated that no markings were observed on R1. LPA interviewed R1’s responsible party (RP) who stated they were told that R1 was screaming and saying they were beating R1 up, but RP did not observe any bruises on R1’s arms except for a small bruise on the wrist that was from a week prior. RP also stated that R1 did not used to be aggressive, but lately that has changed. According to RP, R1 gets agitated very easily, tries to exit, cries, does not like to leave the room, and thinks everyone is mean to R1. RP stated they do not see the staff being mean to R1. RP stated that R1 gets aggressive during showers and there was a particular day on 10/08/2024 where R1 had to have two (2) showers which left R1 agitated. LPA interviewed HSD Nunez and ED Weisbarth who both stated that R1 gets aggressive during showers and pinches staff and self. HSD stated that staff are trained on redirecting and de-escalating aggressive episodes and that R1’s family is aware. HSD also stated that R1 had to be removed from their second shower on 10/08/2024 for their’s the staff’s safety as R1 was having an aggressive episode and scratched staff. HSD provided LPA with a date-stamped picture taken on 10/10/2024 of the small bruise on R1’s forearm. RP confirmed that they were aware of the bruise. During the LPA’s visit on 10/17/2024, the police independently conducted a wellness check on R1 and determined that R1 has severe dementia, and the resident is safe. The LPA reviewed Resident #1’s (R1) records which confirm R1’s dementia diagnosis. Based on interviews and record review, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore, the allegation “Resident was physically abused while in care” is deemed UNSUBSTANTIATED at this time.

No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:

DATE: 11/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/13/2024
LIC9099 (FAS) - (06/04)
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