197610043-7-30-2024-29-AS-KHEN-D85RAX-20240814125149

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610043
Report Date: 07/30/2024
Date Signed: 07/30/2024 02:40:29 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
07/22/2024 and conducted by Evaluator Emily Peraldi

COMPLAINT CONTROL NUMBER: 29-AS-20240722131443

FACILITY NAME:	MEGAN'S PLACE		FACILITY NUMBER:	197610043
ADMINISTRATOR:	OSBORN, ANNIE		FACILITY TYPE:	740
ADDRESS:	7708 ETHEL AVENUE		TELEPHONE:	(818) 853-7654
CITY:	NORTH HOLLYWOOD	STATE: CA	ZIP CODE:	91605
CAPACITY:	6	CENSUS: 5	DATE:	07/30/2024
		UNANNOUNCED	TIME BEGAN:	09:55 AM
MET WITH:	Annie Osborn, Administrator		TIME COMPLETED:	02:55 PM

ALLEGATION(S):

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Facility did not provide a safe environment for residents.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Emily Peraldi conducted an unannounced initial complaint visit to this facility. At 9:55 a.m., the LPA met with staff and explained the reason for the visit. At 10:42 a.m., the Administrator Annie Osborn arrived at the facility.

At 10:05 a.m., the LPA along with staff conducted a physical plant tour. Between 10:06 a.m. and 1:04 p.m., the LPA conducted interviews with the Administrator, one (1) staff and four (4) residents. At 1:05 p.m., the LPA obtained copies of pertinent documents.

Continued on LIC 9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024

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-20240722131443

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: MEGAN'S PLACE	FACILITY NUMBER: 197610043
	VISIT DATE: 07/30/2024

NARRATIVE

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Regarding the allegation: 1.) Facility did not provide a safe environment for residents. It was alleged that a resident’s dog was roaming freely outside the facility and attacked another dog. The complainant’s concern is that the dog’s presence at the facility is not creating a safe environment for the residents in care. During the time of the visit, the LPA conducted interviews with four (4) residents, including Resident #1 (R1). R1 explained that R1 was babysitting a dog for a week at the beginning of July 2024. R1 said that the dog escaped the facility through an open side gate. R1 said that the facility’s side gates are normally closed. R1 said that while the dog was out, the dog attacked another dog. R1 said that the dog was not aggressive and that the dog did not show any aggression towards the other residents or staff. R1 stated that they do have one (1) dog of their own that stays at the facility. R1 said that R1’s dog remains by R1’s side and is not aggressive and has no issues with staff or residents. Resident interviews revealed that the residents feel safe at the facility and did not bring up any safety concerns regarding dogs. Administrator interview revealed that the side gates do stay closed, however on Mondays one of the side gates stay open in order for the gardeners to have access to the backyard. The Administrator stated that side gates will remain closed from now on. Interview with R1 and the Administrator revealed that the dog has left the facility and will not be returning. The Administrator said that R1’s own dog is nice and not aggressive and has no issues with R1 having a dog at the facility. The Administrator stated that herself and her staff are always checking on the health and safety of all the residents in care and would not allow an aggressive dog at the facility. The information obtained during the investigation did not include evidence sufficient to corroborate the allegation. 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.

Exit interview conducted. No citations issued. A copy of the report was issued.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024

LIC9099 (FAS) - (06/04)

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