197609117-8-27-2024-29-AS-KHEN-D8M6TU-20240829210606

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609117
Report Date: 08/27/2024
Date Signed: 08/27/2024 01:44:55 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. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/21/2024 and conducted by Evaluator Kelly Dulek

PUBLIC

COMPLAINT CONTROL NUMBER: 29-AS-20240821161633

FACILITY NAME:	SILVERADO SENIOR LIVING - CALABASAS		FACILITY NUMBER:	197609117
ADMINISTRATOR:	KEITH PAYNE		FACILITY TYPE:	740
ADDRESS:	25100 CALABASAS RD		TELEPHONE:	(818) 222-1000
CITY:	CALABASAS	STATE: CA	ZIP CODE:	91302
CAPACITY:	110	CENSUS: 52	DATE:	08/27/2024
		UNANNOUNCED	TIME BEGAN:	10:52 AM
MET WITH:	Laken Lacy & Taylor Giunto		TIME COMPLETED:	01:50 PM

ALLEGATION(S):

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Resident was financially abused while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kelly Dulek conducted an initial complaint investigation regarding the above noted allegation. LPA met with Regional Director of Operations Taylor Giunto and Interim Administrator Laken Lacy and explained the reason for the visit. Entrance interview conducted.

During today's visit, LPA interviewed both management staff at 10:45AM, conducted interviews with staff at 10:55AM and 11:40AM, a telephonic interview with Resident #1 (R1)'s conservator at 11:58AM, and interview with R1 at 12:12PM. LPA also reviewed and obtained copies of pertinent documents and toured the facility with Regional Director of Operations at 12:53PM. The following was then determined:

The complaint alleges that there was fraudulent activity reported on R1's debit card. LPA reviewed documents for R1. R1's physician's report indicates that R1 is able to manage their own cash resources. An email dated 01/12/2023 and sent from R1's conservator to the facility's social worker authorizes facility Report Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Kelly Dulek	TELEPHONE: (951) 836-3170
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024

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-20240821161633

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: 08/27/2024

NARRATIVE

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staff to use R1's debit card to assist R1 in making online purchases. LPA spoke with R1's financial conservator, who confirmed that R1 does have a debit card in their room at the facility and staff are authorized to assist R1 with expenditures. Conservator indicated that each month R1's debit card is loaded with a specific amount of money that R1 is able to spent throughout the month at their own discretion. Interview with R1 revealed that R1 used their own debit card to purchase music on their phone, which accounts for the alleged "unauthorized charge" that was reported as fraudulent activity. R1 denied the allegation. Therefore, based on interview and record review, there is insufficient evidence to support the allegation or that a violation occurred; the allegation "resident was financially abused while in care" is deemed UNSUBSTANTIATED at this time.

No deficiencies cited. Exit interview conducted. A copy of the report was provided.

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Kelly Dulek	TELEPHONE: (951) 836-3170
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024

LIC9099 (FAS) - (06/04)

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