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Department of
SOCIAL SERVICES
Community Care Licensing
COMPLAINT INVESTIGATION REPORT
Facility Number:
197609049
Report Date:
09/16/2022
Date Signed:
09/16/2022 01:38:19 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
09/13/2022
and conducted by Evaluator
Wendell Smith
COMPLAINT CONTROL NUMBER:
31-AS-20220913121702
FACILITY NAME:
FALLBROOK GLEN OF WEST HILLS
FACILITY NUMBER:
197609049
ADMINISTRATOR:
LILIT CHAPARYAN
FACILITY TYPE:
740
ADDRESS:
6833 FALLBROOK AVE
TELEPHONE:
(818) 883-4123
CITY:
WEST HILLS
STATE:
CA
ZIP CODE:
91307
CAPACITY:
114
CENSUS:
94
DATE:
09/16/2022
UNANNOUNCED
TIME BEGAN:
09:15 AM
MET WITH:
Elizabeth Gonzales
TIME COMPLETED:
11:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Food is not good quality for residents in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Wendell Smith conducted an unannounced subsequent visit to finish investigation into the allegation above.
It is alleged that food served is not of good quality. LPA conducted initial visit on 9/14/22 regarding this allegation. LPA conducted a physical plant tour of the kitchen area from 9:30-10am to see the ability to prepare and store food. LPA observed there to be a sufficient amount of persishable and non perishable food. LPA observed a good amount of fruits and vegetables. LPA received a copy of the menu and alternative menu for residents. LPA conducted interviews with residents from 10-10:45am regarding the quality of food. Based on the information obtained through observation and interviews this allegation is deemed Unsubstantiated at this time. Residents interviewed were happy with the quality of food being served. Exit interview conducted.
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:
09/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
09/16/2022
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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