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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609969
Report Date: 01/30/2025
Date Signed: 01/30/2025 02:15:09 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
03/19/2024 and conducted by Evaluator Christine Yee
COMPLAINT CONTROL NUMBER: 29-AS-20240319173705
FACILITY NAME:VALLEY VISTA SENIOR LIVINGFACILITY NUMBER:
197609969
ADMINISTRATOR:ELIZABETH J WHITTINGTONFACILITY TYPE:
740
ADDRESS:7040 VAN NUYS BLVDTELEPHONE:
(818) 906-4400
CITY:VAN NUYSSTATE: CAZIP CODE:
91405
CAPACITY:164CENSUS: 68DATE:
01/30/2025
UNANNOUNCEDTIME BEGAN:
10:14 AM
MET WITH:Elizabeth Whittington, Executive DirectorTIME COMPLETED:
02:25 PM
ALLEGATION(S):
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Staff are not ensuring that residents are administered their medication(s) as prescribed.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christine Yee conducted a subsequent complaint visit to conduct additional investigation and to deliver the findings for the above allegation. LPA Yee met with Elizabeth Whittington, Executive Director and the reason for today's visit was explained.

On 3/27/24 Licensing Program Analyst (LPA) Emily Peraldi conducted an unannounced initial complaint visit to this facility. At 12:55 p.m., the LPA met with staff and explained the reason for the visit. At 1:10 p.m., the Executive Director (ED) Elizabeth Whittington met with the LPA Peraldi.

At 1:12 p.m., LPA Peraldi conducted an interview with the ED. At 1:15 p.m., LPA requested copies of pertinent documents. At 1:42 p.m., the LPA, along with the Wellness Director conducted a brief physical plant tour. LPA Peraldi determined that further investigation is required prior to issuing a finding. Exit interview conducted with Wellness Director. A copy of the report was issued.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Christine Yee
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2025
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-20240319173705
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: 01/30/2025
NARRATIVE
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A subsequent complaint visit was conducted on 1/28/25 by LPA Christine Yee to conduct further investigation for the above allegation. LPA Yee met with Elizabeth Whittington, Executive Director. LPA Yee provided the reason for the visit. During the subsequent visit, LPA Yee interviewed Elizabeth Whittington, Executive Director at 1:11pm, Staff #1 at 2:44pm, Staff #2 at 4:37pm, Resident #1 at 3:27pm and obtained additional facility files. Based on information obtained on the subsequent visit, it was determined that additional interviews are needed to make a finding for the above allegation. Exit interview was conducted and a copy of this report was provided.

On today's visit, LPA Yee reviewed and obtained copies of the Medication Administration Record for Resident #1 and Resident #2 beginning at 11:12am and clarified information obtained from resident and staff interviews with the Executive Director. Prior to conducting today's visit, LPA Yee also conducted a telephone interview with Staff #3 at 8:42am.

Per interviews conducted regarding the allegation that staff are not ensuring that residents are administered their medication(s) as prescribed and Staff # 3, was specifically named as the alleged perpetrator. Due to Staff #3 being related to the their supervisor, nothing is being done to address the issues with medications. Staff #3 works the night shift from 10pm- 6:30am. Per information provided, Staff #3 works as a caregiver and provides coverage as a medication technician on the days that the regular medication technician is off. Per interviews conducted, majority of the medications are dispensed during the first and second shift. The night medication technician does not really dispense medications. They will dispense PRN medications when the resident request them at night. Per information provided, the facility has only 2 residents who requests their PRN medication at night. Resident #1 does not like taking their PRN Hydrocodone 10/325mg tablet for pain in the day time as it makes them sleepy and is known to requests their hydrocodone regularly at 11pm, unless they are asleep. Resident #1 has also asked for their medication as early as 10:30pm. Sometimes Resident #1 forgets that they took their Hydrocodone and staff has to remind them that they took it already. Staff now leaves the empty pill cup on the night stand as a reminder to the resident. Resident #2 will sometimes ask for their PRN medication occasionally and has been currently in the hospital. Per interview with Resident #1,they have not been refused their medications or had any medication issues. Per interview conducted with Staff #1, who the complainant alleges has information to confirm the above allegation, vehemently denies having any knowledge of medication issues. Staff #1 states that they provide care to the residents and only relay a message tot he Medication Tech when the residents requests their medications.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Christine Yee
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 29-AS-20240319173705
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: 01/30/2025
NARRATIVE
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Page 3
Beyond that they do not touch medications, they do not hang around the medication room to have observed
anything and have no knowledge of any medication issues. They don't know why someone would say that they have any information related to the above allegation. Per interviews conducted, everyone stated that there are no medication issues and if there was, it would have been reported to the Wellness Director and she would have relayed it to the Executor Director. Per interview with the Executive Director, she has not received any complaints from the residents or made aware of any issues regarding medications.


Based on the investigation conducted, there is insufficient evidence to support the allegation that Staff are not ensuring that residents are administered their medication(s) as prescribed. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed unsubstantiated at this time.

No deficiencies were cited on today's visit.


Exit interview was conducted.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Christine Yee
LICENSING EVALUATOR SIGNATURE:

DATE: 01/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3