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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197600690
Report Date: 09/16/2021
Date Signed: 09/16/2021 10:55:54 AM

Substantiated


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., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/10/2020 and conducted by Evaluator Tuesday Cabiness
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20200910110848
FACILITY NAME:THERAPEUTIC LIVING CENTERS FOR THE BLINDFACILITY NUMBER:
197600690
ADMINISTRATOR:HITZ, JADEFACILITY TYPE:
735
ADDRESS:17712 PARTHENIATELEPHONE:
(818) 349-3440
CITY:NORTHRIDGESTATE: CAZIP CODE:
91324
CAPACITY:6CENSUS: 3DATE:
09/16/2021
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Thosha DavisTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff failed to provide adequate supervision to client while in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Tuesday Cabiness met with Lead Staff Thosha Davis and informed her the reason of the visit. Staff contacted House Manager Correthia Mitchell, who LPA spoke to over the phone and inforned her the reason of the visit. Administrator Joshua Cration was not available and was on vacation. LPA visited the facility to deliver the final findings of the allegation mentioned above.

It was alleged that staff failed to provide adequate supervision to client in care. During the investigation, from 09/16/2020 and 09/17/2020, from 2pm to 4pm, LPA conducted interviews, and reviewed documents. Also, on 06/25/2021 and 09/13/2021, from various times, ranging from 9am to 5pm, LPA re-reviewed the complaint and documents pertaining to the complaint. It was revealed, from an incident report submitted to NLACRC (North Los Angeles County Regional Center) that a third-party provider who was assigned to provide services to specific
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2021
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 3
Control Number 31-AS-20200910110848
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., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: THERAPEUTIC LIVING CENTERS FOR THE BLIND
FACILITY NUMBER: 197600690
VISIT DATE: 09/16/2021
NARRATIVE
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clients, observed another client enter the backyard of the facility, and attempted to eat an apple that was discolored and allegedly used for smoking drug paraphernalia. The client was not being supervised by group home staff, when the client attempted to eat the apple. The incident was reported and on 09/03/2020, a meeting was conducted with Regional Center and facility staff, and the Administrator confirmed the incident occurred. A CAP (Corrective Action Plan) was issued to the facility by Regional Center for non-compliance. This is a potential health and safety risk to clients in care. Therefore, based on interviews and documents reviewed, the allegation, “Staff failed to provide adequate supervision to client in care” is SUBSTANTIATED.

No citation will be issued during this visit, due to a similar SUBSTANTIATED finding for the same allegation issued today. The POC (Plan of Correction) was submitted and cleared by LPA; nothing further to to review or assess.


SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20200910110848
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., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: THERAPEUTIC LIVING CENTERS FOR THE BLIND
FACILITY NUMBER: 197600690
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/16/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/16/2021
Section Cited
CCR
80078(a)
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Responsibility for Providing Care and Supervision. (a) The licensee shall provide care and supervision as necessary to meet the client's needs.
This requirement was not met, evidenced by; during interviews and
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POC cleared. Administrator was issued an Corrective Action Plan with Regional Center, in which the facility fulfilled the required obligations in the CAP. LPA received the removal letter
that the CAP was in compliance.
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documents obtained, it was confirmed by the Administrator that a group home staff left clients with the third-party staff for (14) minutes, without notifiying Administration. This is a potential health and safety risks to clients 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.
SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:

DATE: 09/16/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/16/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3