197609496-9-17-2024-31-AS-NMAN-D9HVUU-20240927164518

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609496
Report Date: 04/18/2024
Date Signed: 09/17/2024 02:17:47 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
05/25/2023 and conducted by Evaluator Tihesha Smith

COMPLAINT CONTROL NUMBER: 31-AS-20230525140558

FACILITY NAME:	ENCINO TERRACE SENIOR LIVING		FACILITY NUMBER:	197609496
ADMINISTRATOR:	ARTEAGA, IRMA		FACILITY TYPE:	740
ADDRESS:	16025 VENTURA BLVD		TELEPHONE:	(818) 986-8466
CITY:	ENCINO	STATE: CA	ZIP CODE:	91436
CAPACITY:	85	CENSUS: 48	DATE:	04/18/2024
		UNANNOUNCED	TIME BEGAN:	12:45 AM
MET WITH:	Joel Schochet		TIME COMPLETED:	01:20 PM

ALLEGATION(S):

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Staff did not provide authorized representative with resident's 30-days notice of eviction.

INVESTIGATION FINDINGS:

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On 09/17/24 Licensing Program Analyst (LPA) Nicholas Reed visited the facility to deliver amended document for the visit previously conducted on 05/25/2023. The report was amended to add additional information to support final findings.

On 05/25/2023 Licensing Program Analyst (LPA) Tihesha Smith made an unannounced subsequent complaint visit to this facility at approximately 11:25 am. LPA Smith met the administrator and disclosed the purpose of the visit.

Staff did not provide authorized representative with resident's 30-day’s notice of eviction

On 05/30/2023, during the initial complaint visit, LPA Tihesha Smith conducted interviews with the Director and other facility staff. From approximately 12:40 pm to 1:10 pm, LPA Smith requested and reviewed copies of documents relevant to the investigation.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas Reed	TELEPHONE: 818-307-6280
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024

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 31-AS-20230525140558

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: ENCINO TERRACE SENIOR LIVING	FACILITY NUMBER: 197609496
	VISIT DATE: 04/18/2024

NARRATIVE

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(cont from 9099)

These documents included, but were not limited to, R1’s admission agreement, R1’s account payment summary, a copy of the 30-day eviction notice, and other relevant records. LPA was unable to interview Resident #1 (R1) as they no longer reside at the facility.
Interviews two (2) of two (2) staff revealed that Resident 1 (R1) was self-responsible and did not have a Power of Attorney (POA) on file. One (1) of two (2) staff revealed R1’s friend was in the process of obtaining a POA. The Administrator disclosed that R1 had an overdue balance, which initiated the eviction process. Despite previous discussions about the default balance, R1 made no attempts to settle the unpaid amount. On 02/24/23 a second 30-day eviction notice was issued to R1 due to non-payment.

A brief discussion with the interested party on 04/18/2024 revealed that they started the process of obtaining a POA in May of 2023 which was after R1 received 30-day Eviction Notices on 9/22/2022 and 02/24/2023. LPA Smith reviewed R1’s file and it did not contain any POA records for R1. Records confirmed that R1 was self-responsible, and that the eviction notice was served to R1 in accordance with the policy outlined in the admissions agreement. Additionally, records showed that information and/or communication regarding default and/or return payment was discussed with R1. The resident moved out of the facility on 02/15/2024 with a pending outstanding balance at the facility.

Based on record review and interviews there is not enough sufficient evidence to support the allegation. Therefore, the allegation is Unsubstantiated at this time.

Exit interview conducted. Copy of report provided.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas Reed	TELEPHONE: 818-307-6280
LICENSING EVALUATOR SIGNATURE:	DATE: 09/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2024

LIC9099 (FAS) - (06/04)

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