197608998-3-2-2023-31-AS-RRAZ-CQBK4Q-20230327073440

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608998
Report Date: 03/02/2023
Date Signed: 03/02/2023 02:25:06 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
10/12/2022 and conducted by Evaluator Jose Gary Tan

COMPLAINT CONTROL NUMBER: 31-AS-20221012091416

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: 85	DATE:	03/02/2023
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Susan Weisbarth - Executive Director		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Unlawful eviction

Staff did not provide resident with written notice of fee change for change in level of care

Staff did not install resident's new toilet seat

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) conducted an unannounced subsequent visit at this facility to further investigate the above allegations. LPA met with Executive Director Susan Weistbarth and explained the reason for the visit.

LPA conducted file review between 9:20 AM to 11:00 AM. LPA conducted physical plant tour at 11:15 AM, requested additional facility documents relevant to the investigation at 11:30 AM and interviewed additional staff and residents between 11:45 to 1:20 PM. Regarding the allegation of unlawful eviction, it was alleged that Resident #1 (R1) was being evicted due to non-payment. LPA's record review today between 9:20 AM to 11:00 AM revealed that R1 was never issued an eviction notice but a regular billing invoice and two (2) reminder of overdue invoices as R1's family member (FM) refused to pay. Further review also revealed that R1's family member refused to pay the facility due to the increase in level of care and hired own moving company to remove R1's belongings when R1 was hospitalized on 10/10/2022. (continued on LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Jose Gary Tan	TELEPHONE: (323) 213-1149
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023

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-20221012091416

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: 03/02/2023

NARRATIVE

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(continued from LIC 9099)

Regarding the allegation that Staff did not provide resident with written notice of fee change for change in level of care, LPA's record review today revealed that R1's family member who was paying for R1's stay at the facility on behalf of R1's Power of Attorney who is living out or state, was informed by phone and by email by the staff on 08/17/22 of R1's change of condition and updated services agreement due to higher level of care, which include R1's assessment for the family member to sign. R1's family member acknowledge receipt of the email and copy of the services agreement but did not show up at the facility to sign the updated agreement.

Regarding the allegation that staff did not install resident's new toilet seat, it was alleged that R1's family member brought a shower chair and new toilet seat and the facility refused to install it. LPA's observation during visit on 10/13/22 revealed that the toilet seat at R1's room was not broken and interview with staff on 10/13/22 between 10:15 AM to 1:30 PM revealed that R1's toilet seat was never broken and what was brought was a shower chair and a commode which did not need any installation. LPA did not observe the commode nor the shower chair in R1's former room as it was also taken by R1's family member's movers.

Based on the information gathered during this and prior visit, the allegations are deemed unsubstantiated at this time.

Exit interview conducted. Copy of this report issued.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Jose Gary Tan	TELEPHONE: (323) 213-1149
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023

LIC9099 (FAS) - (06/04)

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