197608478-1-13-2023-29-AS-DPEA-D2X38X-20240229170217

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608478
Report Date: 01/13/2023
Date Signed: 01/13/2023 04:47:04 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
12/12/2022 and conducted by Evaluator Brian Balisi

COMPLAINT CONTROL NUMBER: 29-AS-20221212164812

FACILITY NAME:	SUNRISE ASSISTED LIVING OF WOODLAND HILLS		FACILITY NUMBER:	197608478
ADMINISTRATOR:	PATRICE O'GRADY		FACILITY TYPE:	740
ADDRESS:	20461 VENTURA BLVD		TELEPHONE:	(818) 346-9046
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91364
CAPACITY:	127	CENSUS: 68	DATE:	01/13/2023
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Patrice O'Grady		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff did not allow resident to receive phone calls.

Staff did not provide authorized representative a food menu.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Brian Balisi conducted an unannounced subsequent complaint investigation for the allegations listed above. Upon arrival LPA met with Executive Director Patrice O'Grady and explained the reason for the visit.

On 12/12/2022, the Department received a complaint regarding allegations that Staff did not allow resident to receive phone calls. Staff did not provide authorized representative a food menu.
On 12/15/2022, from 10:30am - 3:45pm, LPA conducted an unannounced initial complaint visit and conducted a physical plant tour, interviewed staff, residents and reviewed and obtained copies of pertinent documentation relevant to the investigation. Today LPA conducted physical plant, interviewed staff and (8) residents and other witnesses.
It was reported that staff did not allow resident to receive phone calls as it was alleged that staff were not allowing Resident 1 (R1) to use their personal phone to speak to R1's responsible party on one occasion and also alleged that staff were keeping the phone turned off on another occasion.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Brian Balisi	TELEPHONE: (818) 421-9171
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2023

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 29-AS-20221212164812

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: SUNRISE ASSISTED LIVING OF WOODLAND HILLS	FACILITY NUMBER: 197608478
	VISIT DATE: 01/13/2023

NARRATIVE

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Continued from 9099

LPA interviews with (12) staff who are often around R1 revealed that most have often observed R1 with their cellphone in close vicinity either in either a shirt pocket or pants pocket, inside of the storage compartment of their walker, but there are times when R1 charges it on their night stand. When R1 is eating in the dining room, R1's phone was often observed face up on the table. Interviews further revealed that each staff has often assisted R1 with making and receiving call upon request from R1. All staff could not recall a time when R1's cell phone was purposely turned off or if R1 was ever not allowed to use their cell phone. LPA conducted physical plant tours and interviews with R1 on 11/29/2022, 12/12/2022 and 12/15/2022 and each time LPA observed R1 with their cell phone. On 12/12/2022, LPA observed Staff 1 (S1) assist R1 in receiving a phone call while R1 was in the dining room. On 01/13/2023, LPA observed Staff 2 (S2) speaking with a memory care resident and resident requested to speak to their family. S2 immediately had staff assist resident in contacting family member through the phone. LPAs interview with (8) residents and a residents personal companion revealed that most stated they did not have a cell phone, but if they needed any assistance with making or receiving calls they are comfortable asking any staff. Based on information gathered during this and previous visits, there is not sufficient evidence to prove this allegation occurred. Therefore the allegation that staff did not allow resident to receive phone calls has been deemed UNSUBSTANTIATED a this time.

It was reported that staff did not provide authorized representative a food menu as it was alleged that multiple verbal requests were made for a weekly menu to preselect meals. LPA's interview with Executive Director revealed that a food menu was given to the responsible party of R1 upon request in August. LPA's physical plant tours on 12/12/2022 and 12/15/2022, revealed food menus for the week were observed at dining room entrance, posted in the elevator , in the activities room and in hallways. LPA interview with (8) residents revealed that most stated they don't recall having to make any changes to any recent meals , but all did not express any concerns or reservations requesting any menu substitutions from staff. Based on information gathered during this and previous visits, there is not sufficient evidence to prove this allegation occurred. Therefore the allegation that staff did not provide authorized representative a food menu has been deemed UNSUBSTANTIATED at this time.

Exit interview conducted and report issued.

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Brian Balisi	TELEPHONE: (818) 421-9171
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2023

LIC9099 (FAS) - (06/04)

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