197609117-9-13-2021-29-AS-JAPL-C79LN8-20210927085352

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609117
Report Date: 09/13/2021
Date Signed: 09/13/2021 04:50:05 PM

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. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/16/2020 and conducted by Evaluator Ashley Smith

COMPLAINT CONTROL NUMBER: 29-AS-20201116081608

FACILITY NAME:	SILVERADO SENIOR LIVING - CALABASAS		FACILITY NUMBER:	197609117
ADMINISTRATOR:	GIUNTO, TAYLOR		FACILITY TYPE:	740
ADDRESS:	25100 CALABASAS RD		TELEPHONE:	(818) 222-1000
CITY:	CALABASAS	STATE:	ZIP CODE:	91302
CAPACITY:	110	CENSUS: 57	DATE:	09/13/2021
		UNANNOUNCED	TIME BEGAN:	10:40 AM
MET WITH:	Taylor Giunto		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff mismanaged medication
Staff failed to follow reporting requirements

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ashley Smith arrived unannounced for a subsequent complaint visit. The LPA met with Taylor Giunto and explained the reason for the visit. During the initial virtual visit on 11/17/2020, the LPA toured the facility with ED Taylor Giunto at 3:30 p.m. During an in-person visit on 5/17/2021, the LPA met with Regional Administrator Jason Russo, toured the facility at 11:23am, and conducted staff interviews from 11:45am - 4pm. In addition, interviews were conducted with two staff members on 07/02/2021 at 8:39 a.m., and 4:12 p.m. During today’s visit, the LPA conducted a medication audit at 3:23 p.m. and conducted staff interviews from 10:44 a.m. – 3:20 p.m.

Regarding the allegation: Staff mismanaged medication
It was alleged that a former staff member was fired for multiple medication errors and for stealing narcotics. Interviews conducted with current staff could not corroborate the above-mentioned claims, and current staff denied having knowledge of any staff, former or current, engaging in any medication-related issues.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Ashley Smith	TELEPHONE: (818) 421-9032
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2021

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 29-AS-20201116081608

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. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: SILVERADO SENIOR LIVING - CALABASAS	FACILITY NUMBER: 197609117
	VISIT DATE: 09/13/2021

NARRATIVE

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Interviews and records review revealed that the former staff in question was written up for various reasons but was not fired from the community due to mismanaging medication. Whereas additional interviews revealed that there was speculation surrounding the firing of a former staff member, sufficient evidence could not be obtained to validate such claims. The LPA conducted a medication audit with the assistance of the Director of Health Care Services at 3:23 p.m. The medication audit did not reveal any discrepancies or medication errors. Based on the investigation, there is insufficient evidence to support the claim that staff mismanaged medication. This allegation is deemed Unsubstantiated at this time.

Regarding the allegation: Staff failed to follow reporting requirements

It was alleged that unusual incidents involvement the mismanagement of medication was not appropriately reported to the Department. Interviews and records review surrounding the allegations revealed insufficient evidence regarding the claim that staff mismanaged medication. Records review revealed that on several prior occasions, the community has submitted Unusual Incident Reports pertaining to medication errors. As such, there was no indication that the community failed to report a medication error and staff understand the requirements as it pertains to reporting. Based on the investigation, there is insufficient evidence to support the claim that the staff failed to follow reporting requirements. This allegation is deemed Unsubstantiated at this time.

No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Ashley Smith	TELEPHONE: (818) 421-9032
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2021

LIC9099 (FAS) - (06/04)

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