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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608998
Report Date: 05/01/2021
Date Signed: 05/01/2021 11:40:20 AM



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
07/07/2020 and conducted by Evaluator Wendell Smith
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20200707161048
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: 71DATE:
05/01/2021
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Susan WeisbarthTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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9
Facility has pests.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Wendell Smith conducted a subsequent complaint visit to finish investigation into the allegation above. LPA conducted the visit over the telephone with administrator Susan Weisbarth.
Regarding the allegation above it is alleged that resident #1 (R1) has had pests such as roaches in their room. LPA had made a previous visit regarding this allegation on 7/14/2020 and 9/30/2020. LPA conducted interviews with staff regarding this allegation. Information obtained through interviews found that R1 did have some pest in their room and that the facility had the room sprayed by a pest control company. LPA received a copy of the pest control company report. Based upon the information obtained this allegation is deemed Substantiated. LPA also investigated this allegation on another complaint 31-AS-20210426092913 and the facility was cited on 4/30/21 for this allegation. Due to this no citation will be issued on this complaint since it was already addressed on another complaint. Exit Interview conducted. Copy of report emailed for signature.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Wendell SmithTELEPHONE: (818) 738-4525
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2021
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 3
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
07/07/2020 and conducted by Evaluator Wendell Smith
COMPLAINT CONTROL NUMBER: 31-AS-20200707161048

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: 71DATE:
05/01/2021
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Susan WeisbarthTIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not providing adequate meal service.
Staff are not meeting resident's hygiene needs.
Staff does not give water to resident when requested.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Wendell Smith conducted a subsequent complaint visit to finish investigation into the allegation above. LPA conducted the visit over the telephone with administrator Susan Weisbarth.
Regarding the allegations above LPA previously conducted complaint visits on 7/14/2020 and 9/30/2020 to interviews residents and staff.
Staff are not providing adequate meal service
It is alleged that resident #1 (R1) was not getting meals on times. LPA interviewed R1 and facility staff. Information obtained through interviews reveal that R1 has not had an issue with getting adequate meals or getting their meals on time. Based upon the information obtained this allegation is deemed Unsubstantiated at this time.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Wendell SmithTELEPHONE: (818) 738-4525
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20200707161048
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: 05/01/2021
NARRATIVE
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Staff are not meeting resident's hygiene needs.
It is alleged that R1 has gone a period of two weeks without receiving a shower. LPA interviewed R1 and facility staff regarding this allegation. Interviews revealed that R1 does receive assistance with showers and has at times refused showers but has never gone two weeks without receiving one. R1 is showered every couple of days. Based on information obtained through interviews this allegation is deemed Unsubstantiated at this time.

Staff does not give water to resident when requested
It is alleged that R1 has not gotten water in a timely manner when it has been requested. LPA conducted interviews with R1 and facility staff. Information obtained through interviews reveal this is not an issue and R1 has gotten water when they have requested. Therefore this allegation is deemed Unsubstantiated.

Exit Interview conducted. Copy of report emailed for signature.
SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Wendell SmithTELEPHONE: (818) 738-4525
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3