197603521-2-7-2023-31-AS-NMAN-CWNUFX-20231016153326

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197603521
Report Date: 02/07/2023
Date Signed: 02/07/2023 03:20:31 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
01/30/2023 and conducted by Evaluator Nicholas Reed

COMPLAINT CONTROL NUMBER: 31-AS-20230130120032

FACILITY NAME:	TLC SUPPORT CENTER		FACILITY NUMBER:	197603521
ADMINISTRATOR:	SANDOVAL,JUAN		FACILITY TYPE:	775
ADDRESS:	7915 LINDLEY AVENUE		TELEPHONE:	(818) 708-1740
CITY:	RESEDA	STATE: CA	ZIP CODE:	91335
CAPACITY:	30	CENSUS: 82	DATE:	02/07/2023
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Juan Sandoval		TIME COMPLETED:	03:29 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff do not follow proper Covid-19 masking safety protocols.

INVESTIGATION FINDINGS:

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

At 1:30 p.m. on 02/07/2023, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with the Administrator and disclosed the reason for the visit. LPA toured the facility at 1:35 p.m. and observed no immediate health or safety concerns.
Regarding the allegation above, it was alleged client #1 (C1) used a mask which was made ineffective due to excess drooling. LPA conducted a file review at 1:45 p.m., interviewed the Administrator at 2:25 p.m., and conducted a record review at 2:45 p.m. From file review, the facility’s plan of operation did not specify requirements around client masking. Title 22 subsection 82095.5 Infection Control Requirements require all staff and visitors to practice and maintain respiratory etiquette, though there are no requirements for clients of the day program. From observations, all staff were wearing N95 respirators. Based on file review and observations, although the allegation may have happened or is valid, there is insufficient evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed UNSUBSTANTIATED at this time. Exit interview conducted. Appeal rights discussed. Copy of report provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Cassandra Harris
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

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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