197600690-7-31-2023-31-AS-MVAO-CUTTVC-20230818150344

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197600690
Report Date: 07/31/2023
Date Signed: 07/31/2023 12:36:57 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 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
11/30/2022 and conducted by Evaluator Evelin Rios

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20221130114500

FACILITY NAME:	THERAPEUTIC LIVING CENTERS FOR THE BLIND		FACILITY NUMBER:	197600690
ADMINISTRATOR:	HITZ, JADE		FACILITY TYPE:	735
ADDRESS:	17712 PARTHENIA		TELEPHONE:	(818) 349-3440
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91324
CAPACITY:	6	CENSUS: 4	DATE:	07/31/2023
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Thosha Davis		TIME COMPLETED:	12:50 PM

ALLEGATION(S):

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Staff do not pick resident up from outing
Staff intimidates resident in care
Staff do not give resident privacy
Staff do not safeguard resident's personal property
Staff will not allow resident a visit

INVESTIGATION FINDINGS:

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On 07/31/2023 at 10:00 a.m. Licensing Program Analyst (LPA) Evelin Rios conducted an unannounced subsequent complaint visit for the above allegations. LPA arrived at the facility and was granted access by staff Thosha Davis. Thosha called Administrator Joshua Cration and LPA explained the reason for the visit. Administrator could not attend todays visit and designated Thosha to sign todays report.

Allegation #1: Staff do not pick resident up from outing.
It is alleged that staff did not pick up R1 from an outing and forget R1. Prior visit on 12/06/2022 revealed in an interview with R1, R1 is driven to church by staff and according to R1 they do not recall being left at church for longer than an unusual period of time. Interview with staff #1 (S1) confirmed there is one driver for the facility and on at least one occasion arrangements were made by R1's family for R1 to be picked up at the facility by an "Uber" and driven to church. Furthermore IPP for R1 does not state 1:1 ratio required for client at this time. Based on interviews and record review this allegation is deemed Unsubstantiated at this time. (LIC9099-C continued on next page)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2023

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-20221130114500

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: THERAPEUTIC LIVING CENTERS FOR THE BLIND	FACILITY NUMBER: 197600690
	VISIT DATE: 07/31/2023

NARRATIVE

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(Page 2 of 3)

Allegation #2: Staff intimidates resident in care.
It is alleged staff will yell at R1 they cannot understand R1 which causes R1 to remain quiet. To investigate this complaint LPA conducted staff interviews on 12/06/2022 and 02/21/2023. Staff interviews deny the allegation. Interview with resident and residents on 12/06/2022 did not corroborate the allegation. There's insufficient evidence to either confirm or deny the above allegation happened. Based on interviews and record review this allegation is deemed Unsubstantiated at this time.

Allegation #3: Staff do not give resident privacy.
It is alleged staff will read R1's notes, R1 writes about staff and staff will not give R1 privacy when R1 is on the phone. To investigate this complaint LPA conducted staff interviews on 02/21/2023. Staff interview with Staff #2 (S2) revealed they have read R1's "journal" about staff and explained the information written is mostly about S2. S2 denies going into R1 purse or bedroom to read journal and instead R1 leaves them open outside their room and therefore S2 considered it open property. According to S2, R1 takes phone calls in the living room. On 12/06/2023 LPA observed Thosha Davis answer the facility phone and passed it to R1. Thosha then told R1 they may take the call in their room. R1 took the call in the dinning area with staff in the kitchen and other residents in the living room. Based on interviews and LPA observation this allegation is deemed Unsubstantiated at this time.

Allegation #4 :Staff do not safeguard resident's personal property
It is alleged staff took R1's purse. To investigate this complaint LPA conducted staff interviews on 02/21/2023. On 02/21/2023 Staff #1 (S1) corroborated on 11/27/2022, R1's purse was missing. According to S1 the purse was later found in a bathroom cabinet. Staff interviews deny the allegation. Interview with resident and residents on 12/06/2023 did not corroborate the allegation. There's insufficient evidence to either confirm or deny the above allegation happened. Based on interviews and record review this allegation is deemed Unsubstantiated at this time.

(LIC9099-C continued)

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20221130114500

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: THERAPEUTIC LIVING CENTERS FOR THE BLIND	FACILITY NUMBER: 197600690
	VISIT DATE: 07/31/2023

NARRATIVE

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(Page 3 of 3)

Allegation #5 Staff will not allow resident a visit.
It is alleged R1 is not allowed a visitor. On 12/06/2022 staff informed LPA, R1 was on an outing with a family member. LPA observed R1 be drooped off by said family member. Staff deny R1 is not allowed visitors, however due to Covid-19 infection control plan they request residents and family to meet in the backyard where there is a covered patio and seating for them. Furthermore LPA interview with responsible person of R1 informed staff to call them first before allowing visitors to visit with R1. According to responsible person they have visited with R1 inside the facility. Staff corroborate, staff and one of R1's visitors had a verbal altercation and staff requested visitor only meet with R1 outside the facility and not inside due Covid-19 protocols. There's insufficient evidence to either confirm or deny the above allegation happened. Based on interviews, observation, and record review this allegation is deemed Unsubstantiated at this time.

Copy of the report provided and exit interview conducted.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:	DATE: 07/31/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/31/2023

LIC9099 (FAS) - (06/04)

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