197603524-1-24-2024-31-AS-NGID-D5VUGB-20240603153359

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197603524
Report Date: 01/24/2024
Date Signed: 01/24/2024 02:45:20 PM

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 DURANDO		FACILITY TYPE:	740
ADDRESS:	1208 WEST H-15		TELEPHONE:	(661) 940-5418
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93535
CAPACITY:	4	CENSUS: 4	DATE:	01/24/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	James Durando		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Facility staff did not follow reporting requirements.

INVESTIGATION FINDINGS:

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On 01/24/24 at 9:30 am Licensing Program Analyst (LPA), Lorena Casillas conducted an unannounced complaint visit to investigate the above stated allegation. LPA met with Administrator James Durando and explained the reason for the visit.

LPA Casillas was greeted by staff #1 (S1) and was granted entry. One (1) resident was observed to be in the living room watching TV, another resident was outside smoking a cigarette, a third (3rd) resident was in their room, the fourth (4th) resident was attending day program.

At 9:45 AM LPA Casillas conducted a physical plant tour with S1. During the investigation, interviews and record reviews were made. LPA requested resident roster, LIC 500 and liability insurance. LPA requested copies of pertinent information relevant to the investigation including but not limited to, resident records, copy of hospital records and any other information pertaining to resident care.
Continued on LIC9099-C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4370
LICENSING EVALUATOR NAME: Lorena Casillas	TELEPHONE: 818-304-2695
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024

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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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: 01/24/2024

NARRATIVE

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Allegation: Facility staff did not follow reporting requirements.

It was alleged that facility staff did not follow reporting requirements. During resident records review it was determined that Special Incident Reports (SIR’s) were not submitted to Community Care Licensing (CCL) for Durando Home Inc. There is record of an SIR being reported on 11/14/2023. In the SIR dated 11/14/2023, it states that “R1 has not shown any progress since her last ER visit on 10-08-2023. Her primary care physician requested we arrange transportation to Hollywood Community Hospital for further assessment and tests.” During investigation LPA observed that there is no record of an SIR being submitted on 10/08/2023 for Durando Home Inc. The SIR’s that were submitted were under Durando Home III, subsequently there is no record nor are there any other SIR’s being submitted from this facility, Durando Home Inc. Due to Durando Home Inc not properly identifying the correct facility that SIR’s should have been sent to, this allegation “Facility staff did not follow reporting requirements.” is SUBSTANTIATED.

Citation Issued. Appeal rights discussed and provided. Exit Interview conducted.

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4370
LICENSING EVALUATOR NAME: Lorena Casillas	TELEPHONE: 818-304-2695
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024

LIC9099 (FAS) - (06/04)

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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: 01/24/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/02/2024 Section Cited CCR 87211(a)(1)	1 2 3 4 5 6 7	87211(a)(1) Reporting Requirements (a) Each licensee shall furnish to the licensing agency …(1) A written report shall be submitted to the licensing...within seven days of the occurrence ...This report shall include… disposition of the case. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	All staff will take state approved vendorised training on Reporting Requirements. Administrator will submit training material and staff sign in sheet to LPA via email by 02/02/2024.
	8 9 10 11 12 13 14	Based on interviews with staff, witnesses and file reviews, the Administrator failed to report incidents that happened to resident in Durando Home Inc. to CCL within 7 days which poses a potential health and safety risk to residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4370
LICENSING EVALUATOR NAME: Lorena Casillas	TELEPHONE: 818-304-2695
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 6

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 DURANDO		FACILITY TYPE:	740
ADDRESS:	1208 WEST H-15		TELEPHONE:	(661) 940-5418
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93535
CAPACITY:	4	CENSUS: 4	DATE:	01/24/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	James Durando		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Facility staff did not ensure that a resident(s) has an appropriate bed.

INVESTIGATION FINDINGS:

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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4370
LICENSING EVALUATOR NAME: Lorena Casillas	TELEPHONE: 818-304-2695
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 4 of 6

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: 01/24/2024

NARRATIVE

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Allegation: Facility staff did not ensure that a resident(s) has an appropriate bed.

It was alleged that the facility did not ensure that residents had an appropriate bed “bed is not appropriate. it is a thin, metal fold-away bed.” Based on facility inspection and interviews it was determined that resident beds are appropriate. During the facility inspection LPA Casillas found that resident beds are beds with an appropriate mattress with springs and bedding, therefore this allegation “Facility staff did not ensure that residents have an appropriate bed.” is UNSUBSTANTIATED.

Exit Interview conducted. Copy of this report provided to Administrator.

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4370
LICENSING EVALUATOR NAME: Lorena Casillas	TELEPHONE: 818-304-2695
LICENSING EVALUATOR SIGNATURE:	DATE: 01/24/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/24/2024

LIC9099 (FAS) - (06/04)

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