197606617-8-8-2024-31-AS-EMIR-DC2NP9-20241217093757

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197606617
Report Date: 08/08/2024
Date Signed: 08/08/2024 01:52:44 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
07/29/2024 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20240729183848

FACILITY NAME:	SAILS NEW CASTLE		FACILITY NUMBER:	197606617
ADMINISTRATOR:	SENAMI LATEJU-LABEODAN		FACILITY TYPE:	735
ADDRESS:	11505 NEW CASTLE AVE		TELEPHONE:	(818) 224-7364
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY:	4	CENSUS: 4	DATE:	08/08/2024
		UNANNOUNCED	TIME BEGAN:	09:22 AM
MET WITH:	Senami Labeodan		TIME COMPLETED:	10:17 AM

ALLEGATION(S):

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Resident sustained injuries while in care due to lack of care and supervision

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Michael Cava conducted a subsequent complaint visit to the facility to close out the investigation regarding the above allegation. LPA met with the administrator, Senami Labeodan, and advised her of the complaint. Per SOC 341, it was reported that on or around 07/26/24, that Resident 1 (R1) sustained unexplained burns on their arm. LPA Cava's investigation consisted of intervies with the administrator, staff and residents. LPA also conducted a record review and a physical plant inspection to insure the health and safety of the residents in care.

Regarding the above allegation, according to the administrator, the marks on R1's arms are not burns, but was an allergic reaction to R1's medication (Depakote). R1 was sent to the hospital for immediate medical attention on 07/26/24, and the diagnoses that R1 was treated for was Depakote Toxicity. Unexplained bruising can be a side effect when taking this medication. Depakote was discontinued. Doctor placed new orders for Gabapentin and Lamotrigine in place. Moreover, administrator stated R1 also has the

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024

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-20240729183848

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., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: SAILS NEW CASTLE	FACILITY NUMBER: 197606617
	VISIT DATE: 08/08/2024

NARRATIVE

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tendency on picking their skin, and injuring self.

LPA interviewed R1, who denies the allegation. R1 stated staff is able to meet their needs, and have never mistreated or been inappropriate with them. During interview with R1, LPA observed R1 to be picking and pealing at their skin, causing self-injury. Staff had to redirect. Interviews with the other three (3) residents could not corroborate with the allegation. Interview with Staff 1 (S1) also do not corroborate with the allegation.

In addition to interviews, a review of R1's records were made, which reveal that on 07/26/24, R1 was sent to the hospital and treated for Depakote Toxicity.

Based on the information obtained, there was insufficient evidence to prove that R1 sustained injuries while in care due to lack of care and supervision. Therefore, the allegation is deemed Unsubstantiated at this time.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2024

LIC9099 (FAS) - (06/04)

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