197604160-3-25-2022-29-AS-JAPL-CDTP9U-20220425110741

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197604160
Report Date: 03/25/2022
Date Signed: 03/25/2022 03:04:50 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. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/04/2021 and conducted by Evaluator Ashley Smith

COMPLAINT CONTROL NUMBER: 29-AS-20210604095550

FACILITY NAME:	LEISURE LIVING INC.		FACILITY NUMBER:	197604160
ADMINISTRATOR:	PAM HASHEMI		FACILITY TYPE:	740
ADDRESS:	30822 JANLOR DR.		TELEPHONE:	(818) 879-9944
CITY:	WESTLAKE VILLAGE	STATE: CA	ZIP CODE:	91362
CAPACITY:	6	CENSUS: 6	DATE:	03/25/2022
		UNANNOUNCED	TIME BEGAN:	11:15 AM
MET WITH:	Tina Santos and Michelle Maurer		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Facility is dirty.
Staff are sleeping in common spaces in the facility
Staff failed to safeguard resident's personal belongings upon death of a resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ashley Smith conducted a subsequent complaint inspection. The LPA met with staff Tina Santos and explained the reason for the visit. Administrator Michelle Maurer was notified regarding the reason for the visit.

During the initial visit conducted on 6/11/2021, the LPA conducted a physical plant tour at 12:03 p.m., reviewed records at 12:17 p.m., conducted interviews at 12:29 p.m., 12:39 p.m., and 1:12 p.m.; and, reviewed the medication closet along with staff at 12:56 p.m. In addition, the LPA interviewed a medical professional whom provided care for Resident #1 (R1) on 11/09/2021 at 10:02 a.m.

During today’s visit, the LPA conducted a physical plant tour at 11:30 a.m., reviewed facility records at 12:00 p.m., reviewed the facility file at 1:05 p.m., and conducted interviews at 11:25 a.m. and 12:10 p.m.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Ashley Smith	TELEPHONE: (818) 421-9032
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2022

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 29-AS-20210604095550

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: LEISURE LIVING INC.	FACILITY NUMBER: 197604160
	VISIT DATE: 03/25/2022

NARRATIVE

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Regarding the allegation: Facility is dirty
It was alleged that the facility was dirty, and that resident belongings were covered in dust. During an initial visit conducted on 6/11/2021, the LPA conducted a physical plant tour and observed the facility to be clean. Resident personal items were observed, and they appeared to be well maintained and were not coated in dust at the time of the visit. However, interviews with staff revealed that prior to the 6/11/2021 visit, the facility had recently undergone a deep cleaning. Hence, during today’s visit, the LPA conducted a physical plant tour of all resident rooms and common spaces. Areas observed included the common areas, dining room, kitchen, resident bedrooms, bathrooms, baseboards, countertops, and resident personal care items. During today’s visit, areas were observed to be appropriately cleaned and the LPA did not observe dirty or unsanitary areas..

Yet, it was further alleged that due to the presence of bed bugs, the facility was unclean. The facility was cited for having bed bugs on 6/11/2021, in which the licensee cleared the deficiency and treated the facility in a timely manner. However, the presence of bed bugs is not a direct correlation or indication of a ‘dirty’ facility, as bed bugs can unknowingly travel into a location via clothing, luggage, purses, backpacks, or other items.

Based on the information obtained through the course of the investigation, there is insufficient evidence to support the claim that the facility is dirty. This allegation is deemed Unsubstantiated at this time.

Regarding the allegation: Staff are sleeping in common spaces in the facility

It was alleged that staff were sleeping in the garage and in the reclining chairs in the living room. Staff interviews revealed that there is a staff room, which is adjacent to the garage. Staff interviews claimed that they slept in their designated room. During the 6/11/2021 visit, the LPA observed the staff room, which is accessible via the garage door. The LPA reviewed the facility file to identify if the staff quarters were indicated on the facility sketch and approved by the Department. The facility file review revealed that the bedroom, which is accessible through the garage, was identified and approved as a staff room since 2003. Information obtained from interviews with representatives from collateral agencies whom had been in the facility denied claims that staff were observed sleeping in common spaces.

Based on the information obtained through the course of the investigation, there is insufficient evidence to support the claim that staff are sleeping in common spaces in the facility. This allegation is deemed Unsubstantiated at this time.

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Ashley Smith	TELEPHONE: (818) 421-9032
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2022

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20210604095550

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: LEISURE LIVING INC.	FACILITY NUMBER: 197604160
	VISIT DATE: 03/25/2022

NARRATIVE

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Regarding the allegation: Staff failed to safeguard resident's personal belongings upon death of a resident
It was alleged that upon the passing of R1, staff removed items that were placed in Resident #1’s (R1) personal trash baskets. Information obtained revealed that as R1 passed away on 5/19/2021, staff had begun cleaning R1’s room and had emptied R1’s personal trash baskets. Staff interviews revealed that staff were unaware that R1 had stored personal belongings in the trash can and had assumed that items in the trash cans needed to be disposed. Additional interviews revealed that staff were able to retrieve the items that were removed from the R1’s personal trash can, and they were given to R1’s responsible party. Whereas the personal trash cans belonged to R1, staff claimed they were unaware that R1 kept personal items in the trash can and assumed items in the trash can were disposable.

Based on the information obtained during the course of the investigation, there is insufficient evidence to support the claim that staff failed to safeguard resident's personal belongings upon death of a resident. Upon notice that the items in the trash can belonged to R1, staff were able to retrieve the items in a timely manner. This allegation is deemed Unsubstantiated at this time.

No deficiencies cited at this time. Exit interview conducted with both Tina Santos and Administrator Michelle Maurer. A copy of the report was issued.

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Ashley Smith	TELEPHONE: (818) 421-9032
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2022

LIC9099 (FAS) - (06/04)

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