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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 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:
71
DATE:
05/01/2021
UNANNOUNCED
TIME BEGAN:
09:00 AM
MET WITH:
Susan Weisbarth
TIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility has pests.
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 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 Harris
TELEPHONE:
(818) 596-4342
LICENSING EVALUATOR NAME:
Wendell Smith
TELEPHONE:
(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 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:
71
DATE:
05/01/2021
UNANNOUNCED
TIME BEGAN:
09:00 AM
MET WITH:
Susan Weisbarth
TIME 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 Harris
TELEPHONE:
(818) 596-4342
LICENSING EVALUATOR NAME:
Wendell Smith
TELEPHONE:
(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 Harris
TELEPHONE:
(818) 596-4342
LICENSING EVALUATOR NAME:
Wendell Smith
TELEPHONE:
(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