197608998-10-9-2024-31-AS-NMAN-D9WVPG-20241010163643

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608998
Report Date: 10/09/2024
Date Signed: 10/09/2024 02:12:08 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 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
12/08/2023 and conducted by Evaluator Antonia Alvizar-Ettima

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20231208105300

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: 93	DATE:	10/09/2024
		UNANNOUNCED	TIME BEGAN:	11:03 AM
MET WITH:	Liliana Solorzano, Resident Care Director and Ivan Saa, Executive Director		TIME COMPLETED:	02:25 PM

ALLEGATION(S):

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Due to insufficient staffing, resident was not checked on timely
Staff locked resident in room

INVESTIGATION FINDINGS:

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At 10:15a.m. Licensing Program Analyst (LPA) Antonia Alvizar- Ettima conducted an unannounced subsequent visit to deliver the finding for the above noted allegations. LPA met with the Resident Care Director (RCD) and Executive Director (ED) and explained the reason for the visit.

During initial visit on 12/18/2023 at 10: 45a.m., LPA Alvizar request resident and staff roster. LPA and Residents Care Director (RCD) conducted a physical plant tour at approximately 11:05 a.m. including the Generation Unit (Dementia Care) to ensure health and safety of the residents. At 11: 55 a.m. LPA requested copies of Admission Agreement, Appraisal Needs and Services, Physician Report, Unusual Incident Reports, MAR’s and other pertinent documents relevant to the investigations. Between 2:00p.m. – 3:55p.m. LPA interviewed RCD, Generation Program Director (GPD) and three (03) staff that provided care in the Generation Unit.
Prior to this visit on 10/07/2024 LPA Antonia Alvizar-Ettima reviewed the information and the documents

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima	TELEPHONE: (818) 383-6108
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024

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-20231208105300

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: CANYON TRAILS AT TOPANGA SENIOR LIVING	FACILITY NUMBER: 197608998
	VISIT DATE: 10/09/2024

NARRATIVE

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previously obtained from the facility. At the time of this visit at 11:10a.m., LPA Alvizar-Ettima and RCD conducted a physical plan tour. During inspection, at approximately 11:30a.m. LPA attempted to interview nine (09) out of fifty-five (55) residents residing at Generation Unit. However, they were unable to respond to LPA’s questions.

1. Due to insufficient staffing, resident was not checked on time.

It was alleged that R1 passed away in their room and staff did not know R1 had passed due to short staffing. Staff interviews reveal that they have sufficient staffing to check on residents timely. Resident Care Director(RCD) indicated that Generation Unit has a total of five (05) staff during the morning and evening shifts. There are three (03) staff during night shift. Residents are being checked out every two hours and as needed. They did not receive any complain about insufficient staffing. During this visit LPA observed residents in Generation Unit and they appeared to be clean and well groomed. A review of facility staff schedule supported the information provided by the staff

Based on observation, interviews and records review there is an insufficient information to support the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

2. Staff locked resident in room.

It was alleged that staff would lock resident (R1) in room residing on the Generation Unit because R1 was a wander risk. Resident Care Director (RCD) and staff interviews reveal that the residents are not locked in the room. All bedroom doors can only be locked from inside by the resident. However, all staff members have a master key and can easily gain access. Interview with three (03) staff that provide care in the Generation Unit revealed that doors are always unlocked, when the resident is in the room, and the staff checks on them every two hours. Some residents carry their own key however they can always open the door from inside the room. RCD and staff indicated that when residents are out in common areas all resident doors are kept locked to prevent wandering residents from entering. During inspection, LPA visited five (05) random selected rooms including R1’s and observed that the door has no auto lock and can easily be opened. However, the door is kept locked from the outside and only a staff member with master key can gain access.

Based on interviews and observation there is an insufficient information to support the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

No health and safety hazard are noted during this visit.
Exit interview is conducted and copy of report was provided.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima	TELEPHONE: (818) 383-6108
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2024

LIC9099 (FAS) - (06/04)

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