197609963-12-20-2021-29-AS-JAPL-C9WU4B-20211221141450

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609963
Report Date: 12/20/2021
Date Signed: 12/20/2021 12:33:26 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
11/29/2021 and conducted by Evaluator Salia Walker

COMPLAINT CONTROL NUMBER: 29-AS-20211129161853

FACILITY NAME:	VALLEY MANOR GUEST HOME		FACILITY NUMBER:	197609963
ADMINISTRATOR:	MARTY BACON		FACILITY TYPE:	735
ADDRESS:	6130 VINELAND AVE		TELEPHONE:	(818) 766-8161
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91606
CAPACITY:	58	CENSUS: 44	DATE:	12/20/2021
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Marty Bacon, Administrator		TIME COMPLETED:	12:35 PM

ALLEGATION(S):

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Residents are using illegal drugs at the facility

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Salia Walker arrived unannounced for a subsequent complaint visit to deliver the investigation finding for the above allegation. The LPA met with Administrator, Marty Bacon, at 9:07 a.m. and explained the reason for the visit.

On 12/7/2021, LPA Salia Walker conducted an unannounced initial 10-day complaint inspection for the above allegation. During the visit, the LPA conducted a physical plant tour with the administrator at 3:42 p.m., to ensure there are no health and safety hazards. From 1:57 p.m. until 2:13 p.m.; and between 3:10 p.m. until 3:20 p.m., the LPA conducted interviews with two (2) out of three (3) staff. From 2:13 p.m. until 2:40 p.m., the LPA conducted an interview with the administrator. From 2:40 p.m. until 3:20 p.m., the LPA reviewed and obtained copies of documents pertinent to the investigation. The LPA determined, at that time, that further investigation was required.
Continue on LIC9099..

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Jeralyn Ann Pfannenstiel
LICENSING EVALUATOR NAME: Salia Walker
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2021

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 29-AS-20211129161853

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: VALLEY MANOR GUEST HOME	FACILITY NUMBER: 197609963
	VISIT DATE: 12/20/2021

NARRATIVE

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Based on record review, interviews with the administrator, staff, and facility clients, although there may be times when clients use illegal drugs in the facility, the facility staff have done everything that is available to them to ensure that this does not occur. Due to client rights, client rooms are not searched nor are clients’ purchases searched when they return to the facility. There is insufficient evidence to support the allegation ‘Residents are using illegal drugs at the facility.’ Although the allegation may have happened or is valid, there is insufficient evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is Unsubstantiated at this time.

Exit interview conducted, a copy of report was issued.

SUPERVISORS NAME: Jeralyn Ann Pfannenstiel
LICENSING EVALUATOR NAME: Salia Walker
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2021

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20211129161853

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: VALLEY MANOR GUEST HOME	FACILITY NUMBER: 197609963
	VISIT DATE: 12/20/2021

NARRATIVE

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During today’s visit, the LPA conducted a physical plant tour with the administrator at 9:08 a.m., to ensure there are no health and safety hazards. From 9:31 a.m. until 11:38 a.m., the LPA conducted interviews with ten (10) facility clients.

Regarding the allegation, ‘Residents are using illegal drugs at the facility,’ the complainant’s concern is that clients at the facility are using “meth” (methamphetamine) and marijuana, but nothing is being done about it. The complainant believes that it is common knowledge to the staff and client families and is concerned for the health and safety of the clients who may be using the drugs, as the facility is not preventing the use of illegal drugs.

During the investigation, LPA Walker conducted interviews with the administrator, staff, and facility clients; and, conducted a record review. The record review revealed that the facility’s Admissions Agreement- Page 17, Section 11: House Rules/ Facility Policies; Section 11(a)(7) states: ‘Possession and/or use of street drugs, alcohol or any illegal medications. The facility may request for drug testing.’ The record review also revealed that clients who have violated the facility rules have been given written warnings, and responsible parties have been notified.
An interview with the Administrator revealed that the administrator believes that the facility has had issues with clients using drugs outside the facility, but no clients have been found using drugs inside the facility. The administrator also revealed that the clients’ responsible parties are always notified when any incident happens, and drug tests have been administered. Interviews with staff revealed that clients are checked ‘every two (2) hours.’ Staff also stated that contraband and/or drug paraphernalia have been found in client’s rooms, but the facility staff have not witnessed any client using illegal drugs at the facility. Interviews with the facility clients revealed that clients who brake house rules are given written ‘warnings.’ Clients also stated that if they are caught with paraphernalia staff confiscate the paraphernalia, and talk to the clients to encourage them not to do drugs. According to clients, ‘staff definitely encourages [us] to not use drugs or drink alcohol. They talk to [us], and explain the side effects of mixing drugs with your meds.’ Clients stated they have witnessed other house mates using illegal drugs outside of the facility, but clients have not been caught doing drug inside the facility. Clients also stated they ‘love’ living at the facility and are ‘happy here.’ Clients stated they feel ‘it’s safe’ living here, and ‘It’s not a bad neighborhood.

Continue on LIC9099C..

SUPERVISORS NAME: Jeralyn Ann Pfannenstiel
LICENSING EVALUATOR NAME: Salia Walker
LICENSING EVALUATOR SIGNATURE:	DATE: 12/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/20/2021

LIC9099 (FAS) - (06/04)

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