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Department of
SOCIAL SERVICES
Community Care Licensing
COMPLAINT INVESTIGATION REPORT
Facility Number:
197608998
Report Date:
05/07/2021
Date Signed:
05/07/2021 04:35:17 PM
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
12/01/2020
and conducted by Evaluator
Wendell Smith
COMPLAINT CONTROL NUMBER:
31-AS-20201201145844
FACILITY NAME:
CANYON TRAILS AT TOPANGA SENIOR LIVING
FACILITY NUMBER:
197608998
ADMINISTRATOR:
SUSAN WEISBARTH
FACILITY TYPE:
740
ADDRESS:
7945 TOPANGA CANYON BLVD
TELEPHONE:
(818) 716-9900
CITY:
CANOGA PARK
STATE:
CA
ZIP CODE:
91304
CAPACITY:
120
CENSUS:
70
DATE:
05/07/2021
UNANNOUNCED
TIME BEGAN:
10:30 AM
MET WITH:
Susan Weisbarth
TIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
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9
Facility staff did not report an incident as required
Facility staff are not providing the Long Term Care Ombudsman requested information
Facility staff are not properly trained
Residents are left in soiled clothing for an extended period of time
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Wendell Smith made an unannounced subsequent visit to finish investigation into the allegations above. LPA met with Susan Weisbarth and explained the reason for this visit.
Regarding the allegation above the inital complaint visit was conducted on 12/8/2020 where interviews were conducted with facility staff.
Facility staff did not report an incident as required
It is alleged that an incident happened back in July 2019 and it could not be confirmed that the incident was reported to Community Care Licensing and that facility staff could not furnish a copy of the reported incident to the Long Term Care Ombudsman (LTCO). LPA was able to obtain the incident report mentioned in this complaint and verify that the incident was reported to Community Care Licensing and that a Soc 341 was submitted also. Based on the information obtained through information obtained this allegation is deemed Unsubstantiated at this time.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME:
Cassandra Harris
TELEPHONE:
(818) 596-4342
LICENSING EVALUATOR NAME:
Wendell Smith
TELEPHONE:
(818) 738-4525
LICENSING EVALUATOR SIGNATURE:
DATE:
05/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
05/07/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099
(FAS) - (06/04)
Page:
1
of
2
Control Number
31-AS-20201201145844
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:
CANYON TRAILS AT TOPANGA SENIOR LIVING
FACILITY NUMBER:
197608998
VISIT DATE:
05/07/2021
NARRATIVE
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Facility staff are not providing the Long Term Care Ombudsman requested information
It is alleged that facility did not provide proof that an incident report was reported to licensing. It is alleged that the incident report was asked about by the LTCO in October 2020 and after three request the facility still has not sent the information. LPA conducted interviews with the administrator who stated that they have sent over the required documentation. LPA obtained a fax sheet from the facility which alleges something related to the incident was faxed to the LTCO but LPA is not able to verify what was sent. Based on the information obtained this allegation is deemed Unsubstantiated at this time.
Facility staff are not properly trained
It is alleged that facility staff in the memory care unit are not properly trained. LPA obtained a staff schedule in the memory care unit. LPA also conducted a walk through of the memory care unit. LPA reviewed a random sampling of memory care unit staff training. Based on information obtained through record review and observation this allegation is deemed Unsubstantiated at this time.
Residents are left in soiled clothing for an extended period of time
It is alleged that residents in the memory care unit are left in soiled clothing for an extended period of time. LPA conducted a walk through of the memory care unit to observe the residents. LPA also obtained a staff roster and resident roster in memory care. LPA was not able to interview residents in memory care due to them not understanding what was being asked. LPA did not observe any residents to be in soiled clothing during this visit. Based upon the information obtained through observation this allegation is deemed Unsubstantiated at this time.
Exit Interview conducted.
SUPERVISOR'S NAME:
Cassandra Harris
TELEPHONE:
(818) 596-4342
LICENSING EVALUATOR NAME:
Wendell Smith
TELEPHONE:
(818) 738-4525
LICENSING EVALUATOR SIGNATURE:
DATE:
05/07/2021
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
05/07/2021
LIC9099
(FAS) - (06/04)
Page:
2
of
2