197610099-3-17-2025-31-AS-NGID-DGWPLP-20250522112500

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610099
Report Date: 03/17/2025
Date Signed: 03/17/2025 02:32:37 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 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
03/12/2025 and conducted by Evaluator Lorena Casillas

COMPLAINT CONTROL NUMBER: 31-AS-20250312131151

FACILITY NAME:	WYNGATE VILLA GARDENS		FACILITY NUMBER:	197610099
ADMINISTRATOR:	CHAVEZ, OSCAR		FACILITY TYPE:	740
ADDRESS:	7634 WYNGATE STREET		TELEPHONE:	(818) 352-4270
CITY:	TUJUNGA	STATE: CA	ZIP CODE:	91042
CAPACITY:	68	CENSUS: 49	DATE:	03/17/2025
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Oscar Chavez		TIME COMPLETED:	02:40 PM

ALLEGATION(S):

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Staff do not ensure that resident's belongings are safeguarded

INVESTIGATION FINDINGS:

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On 03/17/2025 at 10:00 am Licensing Program Analyst (LPA) Lorena Casillas conducted an unannounced complaint visit to investigate the above stated allegation. LPA was greeted by staff who allowed entry and called Administrator Oscar Chavez, to meet with LPA. Administrator arrived shortly after, and LPA explained the reason for the visit. An entrance interview was conducted.

From 10:30 am to 2:00 pm LPA toured the facility with Administrator, interviewed residents and staff, and reviewed facility files. The facility has five (5) buildings with a total of (34) shared bedrooms. The facility is fire cleared for forty six (46) ambulatory and twenty two (22) non-ambulatory residents, ten (10) of which maybe bedridden in building #2 only. LPA requested copies of resident roster, LIC 500, Liability Insurance and Administrator Certificate. LPA requested copies of pertinent information relevant to the investigation including but not limited to admission agreements, resident property inventory sheet, resident medical records, and any information pertaining to residents in care.
Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2025

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-20250312131151

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: WYNGATE VILLA GARDENS	FACILITY NUMBER: 197610099
	VISIT DATE: 03/17/2025

NARRATIVE

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Allegation: Staff do not ensure that resident's belongings are safeguarded.

It is alleged that staff do not ensure that resident's belongings are safeguarded. Regarding this allegation it is reported that Resident #1 (R1)’s room was broken into and R1’s tablet was broken. Interview with Administrator revealed that R1 did report to staff that the tablet was broken on 03/14/25 however Administrator stated that R1 has a tendency of damaging property and accusing others of stealing but when staff investigate, belongings are left forgotten in common areas by R1 and property that is damaged is caused by R1. Interview with two (2) out of two (2) staff assigned to R1’s building revealed that R1 did not directly report anything to them however staff did express that they are aware of R1’s tablet incident. Staff stated R1 has a tendency of making false allegations due to R1’s mental state, furthermore staff revealed that R1 has the ability to lock the room and does so every day, therefore no other residents would have access to R1’s room. Interview with ten (10) out of (10) residents revealed that they have never had issues with their property being stolen or damaged and that staff make sure that their belongings are safeguarded by being vigilant about residents staying out of other residents’ rooms. LPA reviewed resident records and found a property inventory sheet for R1 that did not reflect a tablet. LPA also reviewed the facility admission agreement that reflects that residents agree that they will self-report and update their own property inventory sheet and that they are responsible for their own belongings. LPA did not find a tablet on R1’s inventory sheet but Administrator did confirm that R1 has a broken tablet. Furthermore, Administrator states that they looked over video footage for 03/14/25 when incident was reported to staff and there was no observation of anyone other than R1 entering and/or leaving R1’s room. Footage is only recorded for seven (7) days and as of today’s date anything outside of seven (7) days is not available. LPA interviewed R1 and R1 states that they do not know how the tablet was broken as they did not witness anyone breaking it, R1 just suspects that it was broken by someone else but cannot state who or when. Therefore, based on observations, file reviews and interviews this allegation is deemed unsubstantiated.

Report signed by designee Ricardo Rodriguez as Administrator had to leave before LPA was able to deliver report.

No citation issued. Exit interview conducted. Copy of report provided.

SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Lorena Casillas
LICENSING EVALUATOR SIGNATURE:	DATE: 03/17/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2025

LIC9099 (FAS) - (06/04)

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