195850240-9-8-2023-29-AS-KHEN-CW62SF-20230929173901

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 195850240
Report Date: 09/08/2023
Date Signed: 09/08/2023 01:25:50 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
09/01/2023 and conducted by Evaluator Emily Peraldi

COMPLAINT CONTROL NUMBER: 29-AS-20230901154555

FACILITY NAME:	VARIEL OF WOODLAND HILLS, THE		FACILITY NUMBER:	195850240
ADMINISTRATOR:	JOYCE AQUINO		FACILITY TYPE:	740
ADDRESS:	6233 VARIEL AVE		TELEPHONE:	(818) 651-6018
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91367
CAPACITY:	436	CENSUS: 283	DATE:	09/08/2023
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Joyce Aquino, Administrator		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff are not allowing resident leave the facility

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Emily Peraldi conducted an unannounced initial complaint visit at the facility today. At 10:30 a.m., the LPA met with facility staff and explained the reason for the visit. At 10:40 a.m., the LPA met with the Administrator.

At 10:41 a.m., the LPA conducted an interview with the Administrator. At 11:00 a.m., the LPA conducted a record review and requested copies of pertinent documents. At 11:35 a.m., the LPA, along with staff conducted a brief physical plant tour. Between 11:42 a.m. and 12:25 p.m., the LPA conducted interviews with five (5) residents and five (5) staff.

Continued on LIC 9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Emily Peraldi	TELEPHONE: 818-421-4497
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2023

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-20230901154555

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: VARIEL OF WOODLAND HILLS, THE	FACILITY NUMBER: 195850240
	VISIT DATE: 09/08/2023

NARRATIVE

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Regarding the allegation: Staff are not allowing resident leave the facility. On 09/01/2023, the Department received a complaint alleging that staff are not allowing Resident #1 (R1) from leaving the facility. During the interview with the Administrator, it was revealed that R1 is allowed to leave the facility unassisted per R1’s physician report. However, the Administrator explained that the R1’s family member is hesitated about R1 leaving the facility due to R1’s safety. The Administrator explained that she had several conversations with R1’s family member and told R1’s family member that R1 is allowed to leave, and that the facility can not prevent R1 from leaving. The Administrator said that on 09/07/2023, R1 ordered an Uber and R1 left the facility for one (1) hour to run errands. The Administrator stated that the staff at the front desk are aware that R1 is allowed to leave the facility unassisted. Per interviews and record review it was confirmed that R1 has left the facility on several dates including 09/01/2023, and 09/07/2023. Additionally, interviews with various residents revealed that they do not have any concerns regarding leaving the facility or staff not allowing them. Interviews with staff confirmed that residents are allowed to leave, and that staff cannot restrict or restrain them from doing so. The information obtained during the investigation did not include evidence sufficient to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is deemed Unsubstantiated at this time.

Exit interview conducted. A copy of the report was provided.

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Emily Peraldi	TELEPHONE: 818-421-4497
LICENSING EVALUATOR SIGNATURE:	DATE: 09/08/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2023

LIC9099 (FAS) - (06/04)

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