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Department of
SOCIAL SERVICES
Community Care Licensing
COMPLAINT INVESTIGATION REPORT
Facility Number:
197610032
Report Date:
07/11/2022
Date Signed:
07/11/2022 01:23:16 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
07/07/2022
and conducted by Evaluator
Wendell Smith
COMPLAINT CONTROL NUMBER:
31-AS-20220707160122
FACILITY NAME:
LEISURE GARDEN SENIOR ASSISTED LIVING FACILITY
FACILITY NUMBER:
197610032
ADMINISTRATOR:
JESSICA PELAYA
FACILITY TYPE:
740
ADDRESS:
44523 15TH STREET WEST
TELEPHONE:
(661) 941-4578
CITY:
LANCASTER
STATE:
CA
ZIP CODE:
93534
CAPACITY:
157
CENSUS:
107
DATE:
07/11/2022
UNANNOUNCED
TIME BEGAN:
10:30 AM
MET WITH:
Jessica Pelaya
TIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff is withholding resident's mail.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Wendell Smith conducted an unannounced complaint visit to investigate the allegation above. LPA met with the administrator and explained the reason for this visit.
LPA conducted a brief physical plant tour from 10:30-10:40am to ensure no immediate health and safety issues were present. LPA did not observe any immediate health and safety issues.
It is alleged that resident #1 (R1) is having their mail witheld by facility staff. LPA conducted interviews with R1 from 10:45-11:30am regarding this allegation. LPA interviewed facility staff from 11:30-12pm regarding this allegation. Interviews revealed that R1 had three different packages mailed to them by their friends and that they were sent on Sunday 7/3/22. The packages arrived at the facility on two different dates of 7/6/22 and 7/7/22. R1 confirmed that they received their packages in a timely manner on both of those dates. Interviews with facility staff revealed that they were not aware of any issues of R1 not receiving their mail in a timely manner. Based on the information obtained through interviews this allegation is deemed Unsubstantiated at this time. Exit interview conducted.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME:
Cassandra Harris
TELEPHONE:
(818) 596-4342
LICENSING EVALUATOR NAME:
Wendell Smith
TELEPHONE:
(818) 738-4525
LICENSING EVALUATOR SIGNATURE:
DATE:
07/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
07/11/2022
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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