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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197603524
Report Date: 05/15/2024
Date Signed: 05/15/2024 11:36:12 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 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
01/18/2024 and conducted by Evaluator Lorena Casillas
COMPLAINT CONTROL NUMBER: 31-AS-20240118100349
FACILITY NAME:DURANDO HOME, INC.FACILITY NUMBER:
197603524
ADMINISTRATOR:JAMES DURANDOFACILITY TYPE:
740
ADDRESS:1208 WEST H-15TELEPHONE:
(661) 940-5418
CITY:LANCASTERSTATE: CAZIP CODE:
93535
CAPACITY:4CENSUS: 4DATE:
05/15/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:James DurandoTIME COMPLETED:
11:45 AM
ALLEGATION(S):
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Facility staff did not meet a resident's medical needs.
Facility staff failed to meet the needs of the resident.
INVESTIGATION FINDINGS:
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On 05/15/2024 Licensing Program Analyst (LPA) Lorena Casillas conducted an unannounced subsequent visit to this facility to deliver the final report. LPA met with Staff #1 (S1), who granted access to the facility. S1 contacted the Administrator and LPA explained the reason for the visit. Administrator James Durando arrived shortly after.
On 01/18/2024, the Woodland Hills South Adult and Senior Care Regional Office received a complaint regarding the allegations mentioned above.

On 01/24/2024, LPA Casillas initiated the complaint visit. LPA conducted tour of the facility and obtained copies of pertinent information which includes, but not limited to Physician’s Reports, Hospital records, Appraisal Needs and Services Plan/IPP. LPA also conducted an interview with the Administrator, one (1) staff and one (1) out of four (4) residents who were able to communicate.

Continued on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
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 4
Control Number 31-AS-20240118100349
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: DURANDO HOME, INC.
FACILITY NUMBER: 197603524
VISIT DATE: 05/15/2024
NARRATIVE
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Allegation #1 Facility staff did not meet a resident's medical needs.

Regarding the allegation above, it was alleged that Resident #1 (R1) needs were not met by facility staff. Resident #1 (R1) was not reappraised at the hospital by facility staff, this caused hospital staff to release R1 back to facility. LPA reviewed hospital release paperwork dated 01/13/2024 where there is an indication that R1 needs medical equipment that LPA did not observe at the facility. Furthermore, hospital documents reflect that Physical Therapy is needed for R1, but Administrator was not able to produce any documentation to support that this need was met. Therefore, based on record reviews, interviews, and LPA observations this allegation is deemed Substantiated.

Allegation #2 Facility staff failed to meet the needs of the residents.

Regarding the allegations above it was alleged that Resident #1 (R1) was sent to the hospital alone and unsupervised by facility staff. Based on record review it is determined by a Physicians Report dated 01/25/2024 that R1 is not able to leave the facility on their own and requires supervision. During interviews with the Administrator and S1 it was determined that R1 was sent to the hospital on numerous occasions unsupervised by any facility staff. Therefore, based on interviews and record reviews this allegation is deemed Substantiated.

Please see 9099-D.

Citation issued. Appeals rights discussed and provided. Exit interview conducted. Copy of this report given to Administrator.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 31-AS-20240118100349
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: DURANDO HOME, INC.
FACILITY NUMBER: 197603524
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/22/2024
Section Cited
CCR
87411(a)
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87411 (a) Personnel Requirements (a) Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement is not met as evidenced by:
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POC Administrator agrees to have designated staff to accompany residents to all medical appointments or any appointments that require the resident to leave the facility. A new LIC500 will be submitted to LPA by POC due date via email to reflect additional necessary staff.
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Based on interviews and record reviews the Administrator failed to accompany or have staff accompany R1 to the hospital leaving R1 by themselves. This poses a potential health and safety risk to residents in care.
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Type B
05/22/2024
Section Cited
CCR
87463(c)
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87463 (c) Reappraisals (c) The licensee shall arrange a meeting with the resident…when there is a significant change in the residents’ condition...whichever occurs first, as specified in Section 87467, Resident Participation in Decision Making. This requirement is not met as evidence by:
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POC Administrator agrees to submit a new reappraisal for all residents in care via email, to LPA, by POC due date.
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Based on interviews and record reviews the Administrator failed to meet with R1 at the hospital for a reappraisal. This poses a potential health and safety risk to residents in care.
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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: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 31-AS-20240118100349
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: DURANDO HOME, INC.
FACILITY NUMBER: 197603524
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/22/2024
Section Cited
CCR
87465(a)(1)
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87465 (a)(1) Incidental Medical and Dental Care (a)A plan for incidental medical...care shall be developed by each facility. (1)The licensee shall arrange...medical and...appropriate to the conditions and needs of residents. This requirement is not met as evidence by:
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POC Administrator agrees to provide in-service training for all staff regarding preparing a plan of care for residents when there is a change in care. Training log will be provided to LPA via email by POC due date.
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Based on interviews, record reviews and observations the Administrator failed to follow hospital release instructions for R1 based on hospital discharge paperwork. This poses a potential health and safety risk to residents in care.
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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: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:

DATE: 05/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 4