197609554-9-26-2022-31-AS-NGID-CLFN3D-20221123090608

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609554
Report Date: 09/26/2022
Date Signed: 09/26/2022 12:54:52 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
09/20/2022 and conducted by Evaluator Patrick Shanahan

COMPLAINT CONTROL NUMBER: 31-AS-20220920125621

FACILITY NAME:	SUNSHINE RESIDENTIAL HOME WOODLEY		FACILITY NUMBER:	197609554
ADMINISTRATOR:	JOSE, OYINLOYE AUSTINE		FACILITY TYPE:	735
ADDRESS:	10534 WOODLEY AVENUE		TELEPHONE:	(818) 274-1809
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY:	4	CENSUS: 4	DATE:	09/26/2022
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Victor Adekunle/ Staff		TIME COMPLETED:	11:45 AM

ALLEGATION(S):

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Staff is not allowing resident to leave the facility.

INVESTIGATION FINDINGS:

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Licesnsnig Program Analyst (LPA), Patrick Shanahan, arrived at the facility and was greeted by the facility administrator. The LPA explained the reason for the visit and began the investigation into this allegation.
Allegation 1. Staff is not allowing resident to leave the facility.
LPA was able to speak with staff and residents regarding this incident. LPA was also able to review pertinant facility documents. An interview with the administrator and staff revealed that the resident in question (R1) had moved into this facility on 7/22/22. On 7/23/22 the resident signed a form stating that R1 was leaving the facility and it was allowed. On 9/9/22, R1 moved back to the facility. A review of facility documentation, also showed a sign in/out sheet that showed that R1 was allowed to leave the facility. The LPA was also able to interview another resident who confirmed that staff allow them to leave when they wish. An interview with R1's familiy indicated that R1 was allowed to come and go as R1 pleased.

Based on interviews conducted with the facility staff, facility residents and a review of facility documentation, this allegation is deemed unsubstantiated at this time. Exit interview conducted and report issued.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Patrick Shanahan
LICENSING EVALUATOR SIGNATURE:	DATE: 09/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2022

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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