197610099-1-11-2024-31-AS-RORN-D5HN9R-20240522101622

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610099
Report Date: 01/11/2024
Date Signed: 01/11/2024 02:25:16 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.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
08/18/2023 and conducted by Evaluator Jose Gary Tan

COMPLAINT CONTROL NUMBER: 31-AS-20230818111812

FACILITY NAME:	WYNGATE VILLA GARDENS		FACILITY NUMBER:	197610099
ADMINISTRATOR:	ESPINAL, ALMA		FACILITY TYPE:	740
ADDRESS:	7634 WYNGATE STREET		TELEPHONE:	(818) 352-4270
CITY:	TUJUNGA	STATE: CA	ZIP CODE:	91042
CAPACITY:	68	CENSUS: 43	DATE:	01/11/2024
		UNANNOUNCED	TIME BEGAN:	09:24 AM
MET WITH:	Oscar Chavez - Administrator		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Residents are allowed to smoke inside the facility

Staff shower resident with only cold water

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Gary Tan conducted an unannounced subsequent visit to this facility to further investigate the above allegations. LPA met with administrator Oscar Chavez and explained the reason for the visit.

LPA conducted physical plant tour at 9:44 AM, requested copies of facility documents relevant to the investigation at 10:02 AM and interviewed residents and staff between 10:34 AM to 1:00 PM. Regarding the allegation that Residents are allowed to smoke inside the facility, it was alleged that some residents smoke inside the facility especially residents in room #9. LPA physical plant tour on prior visit on 08/24/23 at 9:18 AM and today at 9:44 AM revealed that no traces of cigarette smell was observed inside the facility especially surrounding Room #9. LPA's interview with six (6) residents on 08/24/23 between 11:00 AM to 1:45 PM and four (4) residents today between 10:34 AM to 1:00 PM revealed that ten (10) out of ten (10) residents interviewed did not smoke or witnessed anyone smoking inside the facility. (continued on LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Jose Gary Tan	TELEPHONE: (323) 213-1149
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024

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 31-AS-20230818111812

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: WYNGATE VILLA GARDENS	FACILITY NUMBER: 197610099
	VISIT DATE: 01/11/2024

NARRATIVE

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(continued from LIC 9099)

Regarding the allegation that Staff shower resident with only cold water, it was alleged that a resident is showered with cold water all the time. LPA's interview with six (6) residents on 08/24/23 between 11:00 AM to 1:45 PM and four (4) residents today between 10:34 AM to 1:00 PM revealed that eight (8) out of ten (10) residents interviewed were assisted by the staff to shower and eight (8) out of eight (8) residents interviewed were showered with warm water. The two (2) residents who did not need assistance showering also revealed that they always shower with warm water. Ten (10) out of ten (10) residents interviewed confirmed that the facility always has hot water.

Based on the information gathered during this and prior visit, the allegations are deemed unsubstantiated at this time.

Exit interview conducted. Copy of this report issued.

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Jose Gary Tan	TELEPHONE: (323) 213-1149
LICENSING EVALUATOR SIGNATURE:	DATE: 01/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/11/2024

LIC9099 (FAS) - (06/04)

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