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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 195850240
Report Date: 03/08/2024
Date Signed: 03/08/2024 04:54:54 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
03/05/2024 and conducted by Evaluator Valeria Conway
COMPLAINT CONTROL NUMBER: 29-AS-20240305121059
FACILITY NAME:VARIEL OF WOODLAND HILLS, THEFACILITY NUMBER:
195850240
ADMINISTRATOR:JOYCE AQUINOFACILITY TYPE:
740
ADDRESS:6233 VARIEL AVETELEPHONE:
(818) 651-6018
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91367
CAPACITY:436CENSUS: 356DATE:
03/08/2024
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Joyce AquinoTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Facility Administrator is not certified
Staff is not TB tested
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Valeria Conway conducted an initial 10-day complaint visit to investigate the above allegations. Upon arrival, LPA met with Administrator/Director of Resident Care, Jocelyn "Joyce" Aquino at 9:02 a.m. The reason for today's visit was explained. Entrance interview conducted.

During today’s visit, at 1:15 p.m., LPA conducted a tour of the physical plant. At 10:08 a.m., LPA requested to review facility files for a random sample of staff. Additionally, at 10:45 a.m., LPA obtained and reviewed copies of pertinent documentation relevant to the investigation. Between 11:20 a.m. and 1:54 p.m., LPA conducted interviews with facility ED, Administrator, and a random sample of facility staff and residents.

Continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Valeria ConwayTELEPHONE: (818) 454-0485
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
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 5
Control Number 29-AS-20240305121059
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: 03/08/2024
NARRATIVE
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Continued from LIC 9099

It was alleged that the facility did not have a certified Administrator. A review of the facility Organizational Chart reflected the Administrator/Director of Resident Care reports to the facility Executive Director (ED). The primary role of the ED is the day-to-day operations of the facility which includes budgeting and all matters related to finances. The facility Administrator/Director of Resident Care handles all matters related to resident care and staffing. Per interviews, staff will bring forth any concerns to the Administrator prior to going to the ED. However, staff and residents are able to discuss any concerns with either party. Moreover, interviews reflected that the ED is assigned by corporate to sign any communication letters to the residents and family. The current Administrator of the facility Joyce Aquino holds a valid Administrator Certificate along with the required training and experience to fulfill this role. Based on information gathered, the Department does not have sufficient evidence to determine that the facility does not have a certified Administrator; therefore, the above allegation is deemed UNSUBSTANTIATED at this time.

It was alleged that facility staff does not have a Tuberculosis (TB) clearance. During today’s visit, LPA reviewed a random sample of staff records and observed all fourteen (14) staff to have the appropriate TB clearances. LPA was informed that the files for the ED and the Sales/Marketing Director are stored offsite and the administrator was unable to access the online copy. However, at approximately 3:08, administrator provided LPA with proof of TB clearances for the ED and Sales/Marketing Director. Moreover, Administrator stated that during the hiring phase all employees are sent to WellnessMart an off-site clinic where TB Testing, finger printing and a physical will be conducted prior to starting employment. Based on the information gathered, the Department does not have sufficient evidence to determine that staff does not have the appropriate TB clearance; therefore, the above allegation is deemed UNSUBSTANTIATED at this time.

No citations issued. A copy of this report was provided.

SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Valeria ConwayTELEPHONE: (818) 454-0485
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
03/05/2024 and conducted by Evaluator Valeria Conway
COMPLAINT CONTROL NUMBER: 29-AS-20240305121059

FACILITY NAME:VARIEL OF WOODLAND HILLS, THEFACILITY NUMBER:
195850240
ADMINISTRATOR:JOYCE AQUINOFACILITY TYPE:
740
ADDRESS:6233 VARIEL AVETELEPHONE:
(818) 651-6018
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91367
CAPACITY:436CENSUS: 356DATE:
03/08/2024
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Joyce AquinoTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff does not have fingerprint clearance and association to the facility
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Valeria Conway conducted an initial 10-day complaint visit to investigate the above allegation. Upon arrival, LPA met with Administrator/Director of Resident Care, Jocelyn "Joyce" Aquino at 9:02 a.m. The reason for today's visit was explained. Entrance interview conducted.

During today’s visit, at 10:00 a.m., LPA conducted a tour of the physical plant. At 10:08 a.m., LPA requested to review facility files for a random sample of staff. Additionally, at 10:45 a.m., LPA obtained and reviewed copies of pertinent documentation relevant to the investigation. Between 11:20 a.m. and 1:54 p.m., LPA conducted interviews with facility Ed, Administrator, and a random sample of facility staff and residents. At 11:25 a.m., LPA and Administrator reviewed the Guardian System.

Continued on LIC 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Valeria ConwayTELEPHONE: (818) 454-0485
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 29-AS-20240305121059
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: 03/08/2024
NARRATIVE
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Continued from LIC 9099

It was also alleged that staff do not have fingerprint clearances and are not associated to the facility. Information gathered during the course of the investigation reflected that Staff #1 (S1), and Staff #2 (S2) are all fingerprint cleared but not associated to the facility. Moreover, a review of the Guardian System reflected that Staff #3 (S3) has been employed at the facility since 09/01/2021 however, was associated at today, 03/08/2024 at 11:35 a.m. Based on the information gathered, the Department has sufficient evidence to determine that facility staff are not associated to the facility. Therefore, the above allegation is deemed SUBSTANTIATED at this time.

Pursuant to Title 22, California Code of Regulations, the following deficiency is cited (refer to LIC 9099-D)

Exit interview conducted. Citations issued. A Copy of report and appeal rights provided.

SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Valeria ConwayTELEPHONE: (818) 454-0485
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 29-AS-20240305121059
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/08/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/09/2024
Section Cited
CCR
87355(e)(2)
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Criminal Record Clearance. (e) All individuals subject to a criminal record review ... shall prior to working, residing, or volunteering in a licensed facility: (2) Request a transfer of a criminal record clearance...This requirement is not met as evidenced by:
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Administrator agreed to make sure all staff are associated to the facility and submit proof by POC due date.
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Based on record review, and interviews, licensee did not comply with the above section by not ensuring 3 out of 3 (S1, S2 and S3) had fingerprint association transferred to the facility prior working, which poses an immediate health and safety risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Valeria ConwayTELEPHONE: (818) 454-0485
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5