197609009-9-13-2022-31-AS-NGID-CJRPVV-20220930113946

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609009
Report Date: 09/13/2022
Date Signed: 09/13/2022 01:54:26 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
09/09/2022 and conducted by Evaluator Patrick Shanahan

COMPLAINT CONTROL NUMBER: 31-AS-20220909162225

FACILITY NAME:	ELWYN CALIFORNIA - YARMOUTH		FACILITY NUMBER:	197609009
ADMINISTRATOR:	TAYO LABEODAN		FACILITY TYPE:	735
ADDRESS:	10512 YARMOUTH AVE		TELEPHONE:	(818) 488-1753
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY:	4	CENSUS: 4	DATE:	09/13/2022
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Tayo Labeodan-Administrator		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff yelled at resident in care.

Staff speaks to residents in an inappropriate manner.

Resident is not allowed to leave the facility.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA), Patrick Shanahan, arrived at the facility in response to the above mentioned allegations. LPA was greeted by the facility LVN and that administrator was called. The administrator was called and arrived a short while later. The LPA explained the reason for the visit.

Allegation 1. Staff yelled at resident in care.
LPA was able to speak with all 4 staff at the facility, attempted to speak with all 4 clients at the facility and the facility administrator regarding this allegation. 3 out of the 4 staff interviewed denied ever hearing any staff member yell at any of the residents. Interviews with residents also indicated that 3 out of 4 residents denied ever being yelled at. The resident (R1) who confirmed to be yelled at was unable to give examples or identify a specific a staff member who yelled at them. R1 denied that staff yelled at any other resident and only yelled at R1. An interview with the administrator, conducted at 11:30 AM, revealed that he was already aware of these allegations.
Continues on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Patrick Shanahan
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022

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 2

Control Number 31-AS-20220909162225

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: ELWYN CALIFORNIA - YARMOUTH	FACILITY NUMBER: 197609009
	VISIT DATE: 09/13/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Administrator stated that he had conducted his own internal investigation and all staff involved denied ever witnessing staff yelling at any of the residents. The administrator confirmed that although he was unable to substantiate, he did hold a training on mandating reporting and different types of abuse. Based on interviews conducted with staff, residents, and the administrator this allegation is deemed to be unsubstantiated at this time.

Allegation 2. Staff speaks to residents in an inappropriate manner.
LPA was able to speak with all 4 staff at the facility, attempted to interview with all 4 clients at the facility and the facility administrator regarding this allegation. 3 out of the 4 staff interviewed denied ever hearing any staff member speak to a resident in an inappropriate manner. Interviews with residents also indicated that 3 out of 4 residents denied ever being yelled at. The one resident (R1) who did state that staff spoke inappropriately to R1, denied ever seeing staff act inappropriately to any of the other residents in care. An interview with the administrator, conducted at 11:30 AM, revealed that he was already aware of these allegations. Administrator stated that he had conducted his own internal investigation and all staff involved denied ever witnessing staff speak inappropriately to any of the residents. The administrator confirmed that although he was unable to substantiate, he did hold a training on mandating reporting and different types of abuse. Based on information available and gained during interviews, this allegation is deemed to be unsubstantiated.

Allegation 3. Resident is not allowed to leave the facility.
LPA was able to speak with all 4 staff at the facility, attempted to interview with all 4 clients at the facility and the facility administrator regarding this allegation. 3 out of the 4 staff interviewed denied ever punishing a resident or denying a resident to leave the facility. Residents interviewed confirmed that they are allowed to go out, however 3 out of the 4 residents were not able to articulate their answers. The administrator and the staff interviewed were all aware of the residents personal rights and denied ever preventing a resident from going into the community. Based on information available and gained during interviews, this allegation is deemed to be unsubstantiated.

Exit interview conducted and report issued.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Patrick Shanahan
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 2