197606660-10-23-2023-31-AS-TAGD-CYWNZE-20231227095411

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197606660
Report Date: 10/23/2023
Date Signed: 10/23/2023 12:18:33 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 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
10/16/2023 and conducted by Evaluator Tuesday Cabiness

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20231016081956

FACILITY NAME:	JOY HOME CENTER		FACILITY NUMBER:	197606660
ADMINISTRATOR:	ZINAIDA AKSELRUD		FACILITY TYPE:	735
ADDRESS:	8042 MCNULTY AVENUE		TELEPHONE:	(818) 571-2247
CITY:	CANOGA PARK	STATE: CA	ZIP CODE:	91306
CAPACITY:	4	CENSUS: 1	DATE:	10/23/2023
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Herbert Amanya & Henry Muhumuza		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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1. Staff did not ensure client in care was adequately supervised
2. Facility did not have an operating telephone
3. Client was not provided personal fixtures and furniture

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tuesday Cabiness conducted an unnanounced complaint investigation visit, and met with direct care staff Henry Muhumuza who was informed the reason of the visit, and allowed LPA to enter. Staff contacted Licensee Herbert Amanya who arrived shortly after and was also informed of the visit. The following was determined:

Allegation # 1: It was alleged staff did not ensure client in care was adequately supervised. During today's visit, from 1015am to 1230pm, LPM interviewed staff, conducted a physical plant inspection and reviewed client documents. According to information obtained, it was revealed to LPA, that client #1 (C1) is currently under a 1:1 supervision, and Regional Center has hired extra staff from an outside agency to provide services to C1. The Licensee reported to LPA, that there was an emergency at another facility, and staff #1 (S1) who was working with the 1:1 extra staff and C1, was told to assist with the emergency. The Licensee contacted other staff to report to the facility, in which, the staff reported within (15) minutes. Although, there was only the outside staff working with C1, there were no other clients in the facility, but the 1:1 client,

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2023

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-20231016081956

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: JOY HOME CENTER	FACILITY NUMBER: 197606660
	VISIT DATE: 10/23/2023

NARRATIVE

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and staff, who was hired to provide services to C1; and the other (3) clients were at day program. Therefore, the 1:1 staff was only with C1 for a short period of time. LPA has determined, that based on interviews, the allegation is Unsubstantiated at this time.

Allegation #2: It was alleged that facility did not have an operating telephone. During today's visit, from 1015am to 1230pm, LPA conducted interviews, physical plant inspection and reviewed client records. It was reported to LPA, the facility has (3) cordless phones, and (2) are located in the staff office. During today's visit, LPA observed (1) of the cordless phones to be located in the dining room area. The Licensee reported to LPA, that if the phone base, which is located in the staff office, is not properly charged, the other phones would not work. LPA called the facility phone number, and all phones were properly working. Although, it was reported the facility phone was not operating correctly, during today's visit, LPA heard the phones ringing, and working properly. Therefore, the allegation is Unsubstantiated at this time.

Allegation # 3: It was alleged, client was not provided personal fixtures and furniture. During today's visit, LPA conducted a physical plant inspection and observed C1's bedroom and personal belongings. It was reported to LPA, that C1 has severe behavior issues, and has destroyed bedroom furniture numerous times. The facility has replaced the furniture, and removed items during the time C1 has been residing in the facility. LPA observed C1 to have a bed, dresser, chair, and lamp. Although, C1 may destroy the items again, the Licensee stated to LPA, they will continue to work with C1, and ensure that furniture is kept in C1's room. Therefore, based on observations, the allegation is Unsubstantiated at this time.

Exit interview and copy of report provided to Licensee.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Tuesday Cabiness
LICENSING EVALUATOR SIGNATURE:	DATE: 10/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2023

LIC9099 (FAS) - (06/04)

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