197609969-11-25-2024-29-AS-KHEN-DBEVER-20241127152247

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609969
Report Date: 11/25/2024
Date Signed: 11/25/2024 04:24:39 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 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
02/28/2023 and conducted by Evaluator Christine Yee

COMPLAINT CONTROL NUMBER: 29-AS-20230228105824

FACILITY NAME:	VALLEY VISTA SENIOR LIVING		FACILITY NUMBER:	197609969
ADMINISTRATOR:	JOLIE HIGGINS		FACILITY TYPE:	740
ADDRESS:	7040 VAN NUYS BLVD		TELEPHONE:	(818) 906-4400
CITY:	VAN NUYS	STATE: CA	ZIP CODE:	91405
CAPACITY:	164	CENSUS: 74	DATE:	11/25/2024
		UNANNOUNCED	TIME BEGAN:	10:09 AM
MET WITH:	Elizabeth Whittington, Executive Director		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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1. Facility staff failed to treat resident with dignity and respect
2. Illegal eviction
3. Facility staff failed to assist with the self-administration of a resident’s medication as prescribed

INVESTIGATION FINDINGS:

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Licensing Program Analyst(LPA) Christine Yee conducted a subsequent unannounced complaint visit to conduct additional investigation and to deliver the findings for the above allegations and met with Elizabeth Whittington, Executive Director. The reason for today's visit was explainted.

An initial unannounced complaint visit was conducted by LPA Yee on 3/2/23. During that visit, LPA Yee reviewed and obtained copies of facility records relevant to the complaint and conducted interviews with Stephanie Walters, Executive Director at 11:09am and 12:53pm, Staff #1 at 1:00pm, Staff #2 at 1:27pm, Staff #3 at 1:58pm and Resident #1 at 11:50am. Based on the information obtained during the intial visit, further investigation was needed to make a finding for the above allegations .Exit interview was conducted and a copy of the report was provided.

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Christine Yee	TELEPHONE: (747) 230-3890
LICENSING EVALUATOR SIGNATURE:	DATE: 11/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 3

Control Number 29-AS-20230228105824

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: VALLEY VISTA SENIOR LIVING	FACILITY NUMBER: 197609969
	VISIT DATE: 11/25/2024

NARRATIVE

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On today's visit, LPA Yee interviewed Elizabeth Whittington, current Executive Director at 10:41am, attempted to conduct a telephone interview with Co-complainant and reviewed facility file at 12:14pm.

Per interviews conducted regarding Allegation #1 - Facility staff failed to treat resident with dignity and respect, the complainant alleges that Stephanie Walters, former Executive Director and Staff #2 are mean and on an unknown date, Staff #2 called Resident #1 an "idiot." Per Co-complaint, they also witnessed that incident where Staff #2 called Resident #1 an "idiot and "stupid." Per the Co-complainant, they reported it to the former Executive Director and was terminated because Staff #2 is friends with the Executive Director. Per review of personnel files, the employment termination was related to the Performance Evaluation conducted in December 2022. Per interview conducted with Resident #1, Staff #2 is nice and they never mentioned that Staff #2 called them an idiot or stupid. Per interview conducted with Staff #2, they deny calling any resident any names. The former Executive Director also denies knowing of any incident where the staff called Resident #1 names. Per information provided, Resident #1 is aggressive, uses bad words and calls the women the "B" word and makes sexual innuendoes. They would ignore or stay away from Resident #1 when they are in a rage. Attempts were made to interview the Co-complaint via telephone on today's visit and LPA Yee was told that they have not worked for the facility for over a year and they don't remember anything. Based on the information received through the interviews conducted, there is insufficient evidence to support the allegation that facility staff failed to treat resident with dignity and respect. It may or may not have happened but there is no preponderance of evidence to support the allegation, therefore the allegation is UNSUBSTANTIATED at this time.

An interview was conducted with Resident #1 regarding Allegation #2 - illegal eviction, the resident indicated that the facility is trying to evict them. Per the interview conducted with Resident #1, they were told to leave the facility. Per interview with Stephanie Walters and Staff #2, they have not served Resident #1 or the resident's POA any eviction notices. However, they are working with Resident #1's family to find other placement since the resident wants to live closer to West Los Angeles and does not like it here. Per information received from interviews conducted, there is insufficient evidence to support the allegation that Resident #1 is being illegally evicted. Therefore the allegation is UNSUBSTANTIATED at this time.

Continued on LIC9099-C

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Christine Yee	TELEPHONE: (747) 230-3890
LICENSING EVALUATOR SIGNATURE:	DATE: 11/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2024

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20230228105824

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: VALLEY VISTA SENIOR LIVING	FACILITY NUMBER: 197609969
	VISIT DATE: 11/25/2024

NARRATIVE

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Per interviews conducted regarding Allegation #3 - Facility staff failed to assist with the self-administration of a resident’s medication as prescribed, the facility would have difficulty with Resident #1 taking their medication. Resident #1 would refuse to take the medication and than half hour later would take the medications. Per Staff interviewed, Resident #1 did not like being woken up for medication. The facility also had problems obtaining the resident's medications and refills. The pharmacy would call the doctor and they did not respond to requests for medications promptly and they were also having insurance issues. The pharmacy would not take Resident #1's insurance and the POA would not change the resident's insurance. Insurance also would not authorize the medications immediately. Based on the interviews conducted there is insufficient evidence to support the allegation that facility staff failed to assist with the self-administration of a resident's medication as prescribed. Therefore, the allegation is UNSUBSTANTIATED at this time.

No deficiencies were cited on today's visit

Exit interview was conducted and a copy of this report was provided.

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Christine Yee	TELEPHONE: (747) 230-3890
LICENSING EVALUATOR SIGNATURE:	DATE: 11/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2024

LIC9099 (FAS) - (06/04)

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