197603296-6-12-2024-31-AS-EMIR-D8XVTT-20240909164339

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197603296
Report Date: 06/12/2024
Date Signed: 06/12/2024 02:51:47 PM

Unsubstantiated

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
06/10/2024 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20240610145500

FACILITY NAME:	FAIRWINDS - WEST HILLS		FACILITY NUMBER:	197603296
ADMINISTRATOR:	ELVIS GUTIERREZ		FACILITY TYPE:	740
ADDRESS:	8138 WOODLAKE AVE		TELEPHONE:	(818) 713-0900
CITY:	WEST HILLS	STATE: CA	ZIP CODE:	91304
CAPACITY:	130	CENSUS: 107	DATE:	06/12/2024
		UNANNOUNCED	TIME BEGAN:	12:21 PM
MET WITH:	Elvis Gutierrez		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff did not treat resident with respect.
Staff yelled at resident.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Mariana Agban and Michael Cava conducted a complaint visit to the facility to investigate the above allegations. LPAs met with the administrator, Elvis Gutierrez, and advised him of the complaint. Today's investigation consisted of interviews with the administrator, staff, and residents. LPAs also conducted a physical plant inspection of the facility to insure the health and safety of the residents, and a review of records.

In regards to the allegations, it was alleged that on or around April 23, 2024, facility administrator yelled at Resident 1 (R1) and accused R1, or R1's pet of bringing scabies into the facility. There were no witnesses identified to confirm these allegations. Interviews with administrator and staff deny the allegations. Interviews with seven (7) of seven residents also deny the allegations, with several residents stating staff and administrator treat them with respect. Based on the information, there was insufficient evidence to corroborate the allegations of staff not treating residents with respect, or staff yelling at residents. Therefore, the allegation is deemed Unsubstantiated at this time. Administrator advised and a copy of this report issued.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 06/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024

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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