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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197600690
Report Date: 06/20/2024
Date Signed: 06/20/2024 02:59:28 PM

Substantiated


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
06/12/2024 and conducted by Evaluator Mariana Agban
COMPLAINT CONTROL NUMBER: 31-AS-20240612122942
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:
06/20/2024
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Oscar Perez TIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Unlawful eviction
INVESTIGATION FINDINGS:
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Licensing Program Analyst(LPA) Mariana Agban conducted an unannounced initial complaint visit for the above allegation. LPA arrived at the facility and was granted access by staff #1 (S1). Administrator arrived shortly after and LPA explained the reason for the visit.During the course of the investigation, interviews and record reviews were made. At 9:25 AM, LPA conducted a physical plan tour, to ensure health and safety of the clients are protected and are in compliance with Title 22 Regulations. At 9:45 am, LPA requested copies of pertinent information which include, but not limited to Physician's Report, Appraisal Needs and Services Plan, Individual Program Plan (IPP), etc., relevant to the investigation. Between 10:00 am-11:00 am, LPA interviewed the Administrator and two (2) staff members. LPA also reviewed documents between 10:00 am- 11:00 am.
Allegation: Unlawful eviction
It was alleged that facility is refusing to accept C1 back to the facility after discharge from the hospital without notice being issued.
( Continue 9099C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
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 3
Control Number 31-AS-20240612122942
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: 06/20/2024
NARRATIVE
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On 05/27/24 C1 had a behavior episode that caused destruction to the home. House Manager and other staff attempted to redirect C1 but they were unsuccessful. House Manger called 911 and LAPD asked everyone in the facility to evacuate. C1 was arrested and transported to the Northridge hospital and placed on 5150 hold. Interview with the Administrator and House Manager revealed that there wasn't a 30-day notice issued to C1. Administrator stated that a 3 day eviction notice was submitted to Regional Center on June 13, 2024. However, Administrator admitted that the 3-day eviction notice was not sent to CCL for approval. Based on the information obtained, the allegation of Unlawful Eviction is Substantiated. Citations issued on the 9099D. Appeal rights are given. Copy of this report delivered.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 31-AS-20240612122942
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/27/2024
Section Cited
CCR
87224(a)(b)
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Eviction Procedures. The licensee may, upon thirty (30) days written notice to the resident, evict the resident for nonpayment of the rate for basic services, failure to comply with state or local law, failure to comply with the general policies of the facility, development of a need not previously identified, and/or a change of use of the facility
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Administrator will review regulation regarding eviction procedures. Administrator agreed to submit a written certification that eviction procedures will be followed.
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87224(b) Eviction Procedures. The licensee may, upon obtaining prior written approval from the licensing agency, evict a resident upon three (3) days written notice to quit. Based on information obtained, the licensee did not comply with the section cited above. Client 1 was taken to the hospital by LAPD and placed on 5150 hold. Administrator did not issue 30 day or 3 day eviction to CCL and refused to accept client back from the facility. This poses a potential Haealth, Saftey, or Prsonal Rights risk to persons in care
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Administrator will issued 30 day notice to Client 1 and request a 3 day eviction approval from the CCLD Woodland Hills Office.
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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: Eva Miller
LICENSING EVALUATOR NAME: Mariana Agban
LICENSING EVALUATOR SIGNATURE:

DATE: 06/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3