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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197606597
Report Date: 09/28/2022
Date Signed: 09/28/2022 04:44:08 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
09/26/2022 and conducted by Evaluator Joscelyn Martinez
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20220926105802
FACILITY NAME:WESTPORT HOMEFACILITY NUMBER:
197606597
ADMINISTRATOR:REX RETOLADOFACILITY TYPE:
740
ADDRESS:10252 EAST AVENUE STELEPHONE:
(661) 944-5779
CITY:LITTLEROCKSTATE: CAZIP CODE:
93543
CAPACITY:20CENSUS: 12DATE:
09/28/2022
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Russel Cambiado TIME COMPLETED:
04:30 PM
ALLEGATION(S):
1
2
3
4
5
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7
8
9
Facility staff withheld resident's mail
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 09/28/22 Licensing Program Analysts (LPA’s) Joscelyn Martinez and Melissa Ruiz conducted an unannounced complaint investigation visit. Upon arrival LPAs were met by staff and the purpose of the visit was explained.

Allegation: Facility staff withheld resident's mail

It is alleged that staff is not providing mail belonging to the residents. To investigate this allegation LPAs conducted interviews with four residents, one staff, and the Licensee. Interviews with four (4) out of four (4) residents stated they receive their mail and do not have any issues with their mail. Licensee and S1 stated once a resident moves out of the facility, the staff will forward the mail to their new address if one is provided. S1 stated recently a resident left the facility and the resident’s mail was forwarded to the new facility. S1 provided the new address to the LPAs and LPAs confirmed the address provided is the new address in where the resident now resides. Based on interviews this allegation is Unsubstantiated.

No deficiencies issued. Report signed and delivered. Appeal rights issued.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Nichelle GillyardTELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Joscelyn MartinezTELEPHONE: (818) 383-6108
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022
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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