197603296-6-7-2024-31-AS-TAGD-D6BSMB-20240617135940

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197603296
Report Date: 06/07/2024
Date Signed: 06/07/2024 03:00:28 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
04/10/2023 and conducted by Evaluator Melissa Spaeth

COMPLAINT CONTROL NUMBER: 31-AS-20230410124655

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: 104	DATE:	06/07/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Catherine Hoard		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Resident sexually abused another resident

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst Melissa Spaeth (LPA) conducted an unannounced subsequent complaint investigation for the allegation(s) listed above. LPA was greeted by Busines Office Manager.

On 4/10/2023, a complaint was received by the Woodland Hills Adult & Senior Care Regional Office. The complaint was referred to Community Care Licensing Division’s Investigation Branch as an assignment to investigate the complaint on 4/13/2023.

The investigation consisted of the following: On 04/11/2023, LPA Spaeth conducted a 10-day visit, toured the physical plant and requested residents’ documentation, the resident roster, and the staff roster. During LPA’s visit, LPA received the requested documentation. On 8/01/2023, LPA Spaeth conducted a subsequent visit and interviewed six staff members and interviewed a resident.

Continued- 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) -596-4334
LICENSING EVALUATOR NAME: Melissa Spaeth	TELEPHONE: (818) 421-2278
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

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 2

Control Number 31-AS-20230410124655

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: FAIRWINDS - WEST HILLS	FACILITY NUMBER: 197603296
	VISIT DATE: 06/07/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

A complete investigation was conducted by IB Investigator, Laura Garcia. During the course of the investigation, Investigator Garcia interviewed the Facility Manager, staff members, resident(s), resident’s relatives and a LAPD Detective.

Regarding the allegation: Resident sexually abused another resident - It’s being alleged that a resident (R1) was raped by another resident (R2) within the facility. In October 2022, it is alleged that R2 entered R1’s room uninvited and raped R1. R1 stated they woke up and R2 was on top of R1. It is also alleged that R2 could have put something in R1’s drink which made R1 sleepy so that the incident could occur. R2 seemed confused about the incident and denied it happened and stated it was consensual. The investigation revealed that a medical test was not able to be completed on R1 due to their inability to identify the specific time and date of the incident.

The LAPD Detective advised the sexual assault allegation was rejected by the District Attorney’s Office due to insufficient evidence and cognitive impairments from both R1 and R2. IB Investigator Garcia’s interview of R1 revealed R1 was unable to provide a date and time of the incident and was unable to provide specific details regarding the incident.

A second investigation was conducted by Laura Garcia. Investigator Garcia interviewed R1 on 4/13/2023. The interview revealed R1 was unable to remember what happened and only remembers waking up to pain. Investigator Garcia requested additional police reports from the LAPD Detective but the Detective informed Garcia no additional incident reports were available.

Based upon interviews with residents, staff members, and the LAPD Detective, the complaint is unsubstantiated.

Exit interview conducted and a copy of the report was given.

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) -596-4334
LICENSING EVALUATOR NAME: Melissa Spaeth	TELEPHONE: (818) 421-2278
LICENSING EVALUATOR SIGNATURE:	DATE: 06/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/07/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 2