197601249-12-5-2023-31-AS-RRAZ-DB6JTW-20241119062032

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197601249
Report Date: 12/05/2023
Date Signed: 12/05/2023 05:27:54 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 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
11/28/2023 and conducted by Evaluator Antonia Alvizar

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20231128103004

FACILITY NAME:	ADULT BASIC LEARNING ENVIRONMENT, INC		FACILITY NUMBER:	197601249
ADMINISTRATOR:	ROBERT MARTINEZ		FACILITY TYPE:	775
ADDRESS:	204 N. VICTORY BLVD.		TELEPHONE:	(818) 842-4933
CITY:	BURBANK	STATE: CA	ZIP CODE:	91502
CAPACITY:	30	CENSUS: 6	DATE:	12/05/2023
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Designated Staff, Maryland Delgado		TIME COMPLETED:	05:30 PM

ALLEGATION(S):

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Staff not maintaining a comfortable room temperature for resident
Staff does not provide hand soap for residents

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Antonia Alvizar made an unannounced complaint visit to this facility. LPA met the Designated Staff, Maryland Delgado and explained that this visit was to conduct an investigation of the above noted allegations.

LPA Alvizar and Ms. Delgado conducted a physical plant tour at approximately 10:45 a.m. During inspection, LPA Alvizar interviewed two (2) staff in the facility, one (1) staff via-phone, two (2) out of six (6) residents including resident #1 (R1). In addition, LPA requested copies of Unusual Incident Reports, Staff and Resident roster, pertinent documents relevant to the investigation at 11:30 a.m.

Staff not maintaining a comfortable room temperature for resident. It is alleged that resident complaints about facility being cold.

To investigate this allegation, LPA conducted inspection, interviews with staff and resident.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2023

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 31-AS-20231128103004

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: ADULT BASIC LEARNING ENVIRONMENT, INC	FACILITY NUMBER: 197601249
	VISIT DATE: 12/05/2023

NARRATIVE

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Staff interviews revealed that R1 is always complaining about being cold and staff covers R1 with blanket. Staff indicated that other residents never complaint about facility being cold. Interview of R1 revealed that facility is cold but staff always covers with a blanket provided by home. At the time of this visit LPA Alvizar observed facility to be at a comfortable room temperature. At approximately 11:50 a.m. thermostats read between 71 -74 degrees.

Based on observation and interviews there is no pertinent information to support the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

Staff does not provide hand soap for residents.

It is alleged that staff does not provide hand soap for residents.

To investigate this allegation, LPA Alvizar conducted inspection, interviews with staff and residents. During inspection LPA Alvizar observed hand soap dispensers on all hand washing stations. At 11:58 a.m. LPA observed staff providing resident with soap and hand over hand modeling on how to wash and rise soap off hands. Staff interviews revealed that some residents refuse to use soap when washing hands but staff encourages them to wash them with soap. Residents interview confirm that staff do provide hand soap.

Based on observation and interviews there is no pertinent information to support the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

Exit interview was conducted and a copy of report was provided to Ms. Delgado.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Antonia Alvizar
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2023

LIC9099 (FAS) - (06/04)

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