197610032-10-10-2023-31-AS-MVAO-CWPSGR-20231017135219

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610032
Report Date: 10/10/2023
Date Signed: 10/10/2023 10:18:02 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 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
09/09/2021 and conducted by Evaluator Melissa Spaeth

COMPLAINT CONTROL NUMBER: 31-AS-20210909151146

FACILITY NAME:	LEISURE GARDEN SENIOR ASSISTED LIVING FACILITY		FACILITY NUMBER:	197610032
ADMINISTRATOR:	LABELLA, MARK J		FACILITY TYPE:	740
ADDRESS:	44523 15TH STREET WEST		TELEPHONE:	(661) 941-4578
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93534
CAPACITY:	157	CENSUS: 110	DATE:	10/10/2023
		UNANNOUNCED	TIME BEGAN:	08:36 AM
MET WITH:	Jessica Pelaya		TIME COMPLETED:	10:15 AM

ALLEGATION(S):

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Resident belongings are not being safeguarded.
Staff withholding residents PNI funds
Staff not providing a safe environment for resident.

INVESTIGATION FINDINGS:

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This is an amended copy of the report previously issued on 9/10/2021 and 10/20/2022. This report supersedes reports previously issued. The findings for this complaint remain the same.

Licensing Program Analyst (LPA) Melissa Spaeth conducted an unannounced subsequent complaint investigation for the allegation(s) listed above. At the time of the initial visit, LPA signed in at the sign in station and was greeted by Administrator Jessica Pelaya. LPA explained to Administrator the above allegations.

The investigation consisted of the following: On 9/10/2021, LPA Spaeth conducted a 10-day visit, toured the physical plant, requested documents, interviewed Administrator and client (C1). On 10/20/2022, LPA interviewed staff, clients, and Administrator.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) -596-4334
LICENSING EVALUATOR NAME: Melissa Spaeth	TELEPHONE: (818) 421-2278
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

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-20210909151146

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: LEISURE GARDEN SENIOR ASSISTED LIVING FACILITY	FACILITY NUMBER: 197610032
	VISIT DATE: 10/10/2023

NARRATIVE

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Regarding the allegation: Resident belongings are not being safeguarded. It’s being alleged that staff wanted clients to leave their doors open and a client (C1) stated their personal belongings were missing. C1 was interviewed and stated they left the facility, observed Administrator locked their door when they left, returned, and observed items were missing. LPA interviewed the Administrator and three staff members who stated there were no clients who reported personal items missing from their room. Staff also stated some clients do not lock their rooms when leaving. Clients are encouraged by staff to always lock their room door. LPA interviewed thirteen clients who stated staff always encourage clients to lock their room door when leaving. The thirteen clients stated they did not have any personal items missing because they lock their own rooms. Facility confirmed residents are responsible for their personal belongings.

Regarding the allegation: Staff withholding residents personal and incidental funds (P&I). It’s being alleged that a client did not receive P&I for the last three months. During LPA’s 9/10/2021 visit, LPA spoke to C1 who stated P&I was up to date. LPA interviewed thirteen clients who stated there have not been any issues regarding receipt of P&I. LPA interviewed five staff members who stated clients receive P&I and there have not been any reports from clients stating there are issues with their P&I. Staff (S5) stated they give P&I to clients twice a month. LPA Spaeth received copies of the P&I ledgers on 10/06/2023. LPA observed the P&I ledger which indicates each client received P&I twice a month, the clients signed the report indicating they received the money and the P&I balance is up to date and accurate.

Regarding the allegation: Staff not providing a safe environment for a resident. It’s being alleged a client has been bullying other residents and been bullying C1. LPA interviewed C1 who stated other client did not hit C1 and stated C1 and the other client worked out their differences. LPA interviewed thirteen clients who stated another client has not bullied them. LPA interviewed five staff members who stated clients have not reported abuse by another resident.

Based on LPA’s observation, interviews conducted, the preponderance of evidence standard has not been met. Although the allegations 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 allegations are unsubstantiated.

An exit interview was conducted, and a copy of the report was given.

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) -596-4334
LICENSING EVALUATOR NAME: Melissa Spaeth	TELEPHONE: (818) 421-2278
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

LIC9099 (FAS) - (06/04)

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