197608745-11-1-2022-31-AS-MVAO-CNNTTV-20230202140121

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608745
Report Date: 11/01/2022
Date Signed: 11/01/2022 04:09:31 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
05/11/2021 and conducted by Evaluator Tuesday Cabiness

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20210511160041

FACILITY NAME:	PARADISE SENIOR LIVING -1		FACILITY NUMBER:	197608745
ADMINISTRATOR:	ANGELA ANGLE APOYAN		FACILITY TYPE:	740
ADDRESS:	8435 AURA AVENUE		TELEPHONE:	(818) 626-3338
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91324
CAPACITY:	6	CENSUS: 5	DATE:	11/01/2022
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Angela Apoyan		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff coerced resident

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Tuesday Cabiness and Joscelyn Martinez conducted a subsequent visit to further investigate the allegations mentioned above. The following was
determined:

Allegation # 1: Staff coerced resident. On 05/20/2021, 09/16/2021, and 11/01/2022, from various times, ranging from 930am to 415pm, LPA T. Cabiness reviewed resident records, and conducted interviews with the complainant, staff, and resident #1 (R1). It was alleged staff coerced resident into signing documents without notifying the proper representative. LPA observed the documents in question, and determined that facility was communicating with the POA, via cellphone and email, the first day of R1 being admitted. Although the POA was aware, and R1 signed the documents, R1 reported to LPA, it was not coerced. Therefore, based on interviews, the allegation “Staff coerced resident” is UNSUBSTANTIATED at this time.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Tuesday Cabiness	TELEPHONE: (818) 299-4975
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2022

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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