195850240-1-2-2024-29-AS-DPEA-CZXUUB-20240129145317

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 195850240
Report Date: 01/02/2024
Date Signed: 01/02/2024 03:53:17 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
12/29/2023 and conducted by Evaluator Brian Balisi

COMPLAINT CONTROL NUMBER: 29-AS-20231229150057

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: 329	DATE:	01/02/2024
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Joyce Aquino -		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff do not ensure hot water is available to residents

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced complaint visit to investigate the allegation listed above. Upon arrival LPA met with Administrator Joyce Aquino and explained the reason for the visit.

At approx. 2:30pm, LPA conducted physical plant, interviewed residents, staff and reviewed and obtained copies of pertinent documentation relevant to the investigation.

It was alleged that staff do not ensure hot water is available to residents as it was reported that last Friday 12/29/2023, the facility was without hot water due to facility neglect. Interviews conducted with nine (9) residents revealed that all nine (9) residents did not express any immediate or potential concerns of staff not ensuring residents have hot water available.

Continued on 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Brian Balisi	TELEPHONE: (818) 421-9171
LICENSING EVALUATOR SIGNATURE:	DATE: 01/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2024

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-20231229150057

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: VARIEL OF WOODLAND HILLS, THE	FACILITY NUMBER: 195850240
	VISIT DATE: 01/02/2024

NARRATIVE

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Continued from 9099

All nine (9) residents also stated they were informed on the morning of 12/28/2023, that water will be shut off from 7:00 p.m. to 9:00 a.m. the next morning to install a pressure release valve (PRV). During the shut off residents were provided with drinking water and gallon sized water bottles to be poured into the toilet tank. Additional staff were scheduled to work. Group notifications were sent out via the facility's K4 system to advise all residents, family members and responsible representatives of the water shutoff notice. Based on the information gathered during the investigation, the department does not have sufficient evidence to confirm this allegation occurred. Therefore, the allegation that “Staff do not ensure hot water is available to residents” has been deemed Unsubstantiated at this time.

Exit interview conducted and copy of report issued.

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Brian Balisi	TELEPHONE: (818) 421-9171
LICENSING EVALUATOR SIGNATURE:	DATE: 01/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/02/2024

LIC9099 (FAS) - (06/04)

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