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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608998
Report Date: 02/21/2024
Date Signed: 02/21/2024 06:18:25 PM

Substantiated


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
12/07/2023 and conducted by Evaluator Angela Panushkina
COMPLAINT CONTROL NUMBER: 31-AS-20231207111856
FACILITY NAME:CANYON TRAILS AT TOPANGA SENIOR LIVINGFACILITY NUMBER:
197608998
ADMINISTRATOR:SUSAN WEISBARTHFACILITY TYPE:
740
ADDRESS:7945 TOPANGA CANYON BLVDTELEPHONE:
(818) 716-9900
CITY:CANOGA PARKSTATE: CAZIP CODE:
91304
CAPACITY:120CENSUS: 90DATE:
02/21/2024
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Susan Weisbarth, Administrator TIME COMPLETED:
01:20 PM
ALLEGATION(S):
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Staff are financially abusing resident
INVESTIGATION FINDINGS:
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At 12:00pm, Licensing Program Analyst (LPA) Angela Panushkina a subsequent visit to deliver final findings. LPA met with the Executive Director and Resident Care Director and explained the reason for the visit.

During the initial visit made on 12/11/2023, by LPAs Panushkina and Rahimi, interviews and record reviews were made. At 9:30am, LPAs requested resident and staff roster. At 9:35am, LPAs requested copies of pertinent information which include, but not limited to Admission Agreement, Physician’s Report, Appraisal Needs and Services Plan, etc. relevant to the investigation. At approximately 10:00am, LPAs conducted a physical plant tour, to ensure health and safety of the residents are protected and physical plant is in compliance with Title 22 Regulations. Between 10:10am – 2:00pm, LPAs interviewed the Administrator, Resident Care Director, Generation Program Director, five (5) staff and seven (7) out of nine (9) residents, who were able to communicate. Moreover, LPA contacted and interviewed Staff #1 (S1).
Continue on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Nichelle GillyardTELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Angela PanushkinaTELEPHONE: 747-230-3364
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2024
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 3
Control Number 31-AS-20231207111856
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: 02/21/2024
NARRATIVE
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The complainant’s concern was that staff financially abused a resident in care by cashing personal checks.
The investigation findings revealed that Resident #1 (R1) had been living at this facility since May 26th, 2022. LPA reviewed the Admissions Agreement, Physician’s Report (dated on 05/12/2022), and Care Appraisal (dated on 10/30/23) which indicated that R1 is able to manage own Cash Resources. Interview with R1’s Trustee/Power of Attorney (POA) revealed that around October 2023, POA discovered that R1’s checkbook had gone missing. Upon discovery, POA placed a stop on all missing checks. However, no police report was filed. POA also informed LPA that during their review of the bank statements, POA discovered that eleven (11) checks were cashed and signatures on the checks were forged. Review of eleven (11) checks revealed that nine (9) out of eleven (11) check were payable to Staff #1 (S1).
LPA interviewed S1 on (12/11/23) at (2:07pm). Interview revealed that on July 15, 2023, while taking a break, S1 found R1’s checkbook by an intersection near the facility and took it to their car. After the break, S1 returned to work and did not turn in the checkbook.
Once S1’s shift was over at 10:30pm, S1 discovered that their car was stolen and filed a police report. However, S1 did not indicate in the report that R1’s checkbook was left in the car. Moreover, interview with S1 also revealed that as of 12/11/23, S1 failed to report the incident with R1’s checkbook to the Executive Director.
Interviews with the Executive Director and a Business Office Director revealed that R1 never reported checks missing and they were unaware of the fraudulent activities, however when brought to their attention the Executive Director immediately placed S1 on a suspension and conducted their internal investigation. On 12/13/23, the Executive Director filed a Police Report and LPA receive a copy of the report on 02/19/24. Review of the Report revealed that R1’s checkbook disappeared from the room several months ago, but R1 was not aware about the transactions being made on his/her account until notified by R1’s attorney. Review of Police Report also indicated that R1 did not wish to prosecute. Lastly, Officer’s investigation revealed that nine checks were written to S1 for the amount of $8,140.00 and two checks to a person, not associated to this facility, for the amount of $1300.00. First check deposit was made on 06/29/23 and the last check was cashed on 11/30/23. During today's visit, the Executive Director informed LPA that as of 02/13/24, S1's employment was officially terminated. Based on the information gathered, there is sufficient evidence to conclude that the above allegation is Substantiated.

Deficiency issued per CA code of Regulations Title 22 on LIC-9099D


Exit interview conducted, appeal rights explained, and a copy of this report signed and delivered.
SUPERVISOR'S NAME: Nichelle GillyardTELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Angela PanushkinaTELEPHONE: 747-230-3364
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20231207111856
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/21/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/29/2024
Section Cited
CCR
87205(a)
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Accountability of Licensee Governing Body. The licensee... shall exercise general supervision over the affairs of the licensed facility and establish policies concerning its operation... welfare of the individuals it serves.
This requirement is not met as evidenced by:
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Licensee is responsible for reimbursing R1's money paid to facility Staff #1 S1 in the amount of $9,440.00. During today's visit LPA received a proof of reimbusment.

Deficiecy is cleard durng today's visit
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Based on interview and record reviews, licensee did not comply with the section cited above. Facility Staff #1 (S1) fanancially abused R1 by cashing nine (9) out of eleven (11) checks, which poses/posed a potential health and safety risk to resident in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Nichelle GillyardTELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Angela PanushkinaTELEPHONE: 747-230-3364
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3