197609853-8-5-2021-31-AS-MVAO-CFURNN-20220629131035

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609853
Report Date: 08/05/2021
Date Signed: 08/05/2021 03:37:28 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
08/05/2021 and conducted by Evaluator Cassandra Harris

COMPLAINT CONTROL NUMBER: 31-AS-20210805120509

FACILITY NAME:	REESEJOY CARE HOME II		FACILITY NUMBER:	197609853
ADMINISTRATOR:	RAMIREZ, ROBERTO		FACILITY TYPE:	740
ADDRESS:	17544 SAN JOSE ST		TELEPHONE:	(805) 832-8792
CITY:	GRANADA HILLS	STATE: CA	ZIP CODE:	91344
CAPACITY:	6	CENSUS: 4	DATE:	08/05/2021
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Roberto Ramirez		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Resident's bedroom furniture was replaced with cheaper furniture
Facility staff are not taking resident to doctor's appointments
Facility is not sanitary

INVESTIGATION FINDINGS:

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Licensing Program Manager (LPM) Cassandra Harris along with Licensing Program Analyst (LPA) LaQueena Lacy conducted an initial 10-day complaint visit. It is being alleged that R1's bedroom furntiure was replaced with lower quality furntiure, that facility staff are not taking R1 to R1's doctor appointments, and that the facility is not sanitary. During today's visit, LPM and LPA toured the physical plant, interviewed staff, interviewed residents, interviewed relevant parties, and reviewed records.

- Resident's bedroom furniture was replaced with cheaper furniture
Based on interviews, R1 was originally residing in a different room and R1's current room previously had different furniture. The allegation states that the current furniture is of lesser quality that the previous furniture. All of the furniture is property of the facility. R1 did not come with any furniture of their own. There are no functional concerns about the furniture in R1's room. Based on physical plant tour, LPM and LPA did not observe any defects of the furniture in R1's room.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kit Chan	TELEPHONE: (818) 596-4334
LICENSING EVALUATOR NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021

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 31-AS-20210805120509

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: REESEJOY CARE HOME II	FACILITY NUMBER: 197609853
	VISIT DATE: 08/05/2021

NARRATIVE

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- Facility staff are not taking resident to doctor's appointments
Based on interviews, staff ensure that resident's attend doctor's appointments by arranging for transportation. If needed, staff will accompany residents to their appointments. Based on staff and relevant party interviews and a review of records, R1 is on hospice and hospice nurses visit R1 twice per week. R1's hospice care plan is overseen by the hospice doctor. Per staff interviews, if R1 had additional doctor's appointments, transportation would be arranged, however, R1 has not recently had additional doctor's appointments. Administrator also personally takes residents to doctor's appointments as needed.

- Facility is not sanitary
During the physical plant tour, LPM and LPA did not observe unsanitary conditions. There was sufficient lighting and furniture in common areas and the facility was observed to be clean at the time of the visit.

Based on information obtained, the allegations are deemed unsubstantiated at this time.

Exit interview conducted, appeal rights discussed, and a copy of the report was issued

SUPERVISOR'S NAME: Kit Chan	TELEPHONE: (818) 596-4334
LICENSING EVALUATOR NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021

LIC9099 (FAS) - (06/04)

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