197609632-4-17-2024-29-AS-DPEA-D4U2CH-20240430171647

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609632
Report Date: 04/17/2024
Date Signed: 04/17/2024 06:34:07 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
11/30/2023 and conducted by Evaluator Zabel Chochian

COMPLAINT CONTROL NUMBER: 29-AS-20231130132649

FACILITY NAME:	RESERVE AT THOUSAND OAKS, THE		FACILITY NUMBER:	197609632
ADMINISTRATOR:	SPENCER, ELIZABETH		FACILITY TYPE:	740
ADDRESS:	3575 N. MOORPARK ROAD		TELEPHONE:	(805) 492-2471
CITY:	THOUSAND OAKS	STATE: CA	ZIP CODE:	91360
CAPACITY:	170	CENSUS: 141	DATE:	04/17/2024
		UNANNOUNCED	TIME BEGAN:	12:30 AM
MET WITH:	Elizabeth Spencer		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Facility staff are not communicating with residents or their representatives regarding outbreak updates.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Zabel Chochian conducted a subsequent complaint visit to the facility. The purpose of the visit is to deliver investigation finding. Upon arrival LPA met with Executive Director Elizabeth Spencer and explained the reason for the visit. Entrance interview conducted.

On 11/30/2023, Community Care Licensing Division received the above complaint allegation. It was alleged that the facility had an "intestinal virus" outbreak on or about 11/17/2023. All activities and the dining room were shut down since that date. It was reported that since 11/24/2023 there have been no residents with the illness however the activities and dining room were still closed. It is unknown why. No one at the facility is communicating with the residents or families.

Investigation into the allegation consist of interview with staff on 12/07/202 between 3:15pm-4pm and review of facility records pertaining to the facility “norovirus outbreak” on 12/07/2023 and 12/09/2023.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Zabel Chochian	TELEPHONE: (818) 419-5440
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

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 29-AS-20231130132649

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: RESERVE AT THOUSAND OAKS, THE	FACILITY NUMBER: 197609632
	VISIT DATE: 04/17/2024

NARRATIVE

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In addition, telephonic interview was conducted with twelve (12) randomly selected residents and other potential witnesses through-out the course of investigation and on 04/17/2024 from approximately 9:30am-11:30am.

Executive Director Elizabeth Spencer stated that the residents and families were update as she would receive information/updates from Ventura County Public Health (VCPH). According to Ms. Spencer the Community dining and group activities were stopped and resumed per order from VCPH. Ms. Spencer provided records confirming communication with residents and families. Records provided included but not limited to viral outbreak memo letter dated 11/16/2023 and 11/24/2023 providing notification to residents and families of the outbreak and updates; log of the facility “viral outbreak messaging” alert updates sent via phone messaging and live contact; and communication record from 11/16/2023 – 12/07/2023 between the facility and the VCPH from the onset of the outbreak to the VCPH clearance. Staff also confirmed that Executive Director and staff kept residents and families update with the progress and status of the outbreak as they were informed by VCPH. Twelve out of twelve residents and other potential witnesses interviewed confirmed that facility Executive Director and staff kept residents and families up to date with the outbreak back in 11/2023 - 12/7/2023. Resident and families reported no concern with the way the outbreak was handled. Residents confirmed receiving continuous updates by Executive director via letter, phone and in person (live) by staff.

Based off the information obtained during the investigation, the Department does not have sufficient evidence to support the allegation of “Facility staff are not communicating with residents or their representatives regarding outbreak updates.” Therefore, this allegation is deemed Unsubstantiated at this time.

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Zabel Chochian	TELEPHONE: (818) 419-5440
LICENSING EVALUATOR SIGNATURE:	DATE: 04/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/17/2024

LIC9099 (FAS) - (06/04)

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