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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610099
Report Date: 08/24/2023
Date Signed: 08/24/2023 02:59:36 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 GARDENSFACILITY NUMBER:
197610099
ADMINISTRATOR:ESPINAL, ALMAFACILITY TYPE:
740
ADDRESS:7634 WYNGATE STREETTELEPHONE:
(818) 352-4270
CITY:TUJUNGASTATE: CAZIP CODE:
91042
CAPACITY:68CENSUS: 54DATE:
08/24/2023
UNANNOUNCEDTIME BEGAN:
08:54 AM
MET WITH:Oscar Chavez - AdministratorTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Staff withhold resident's EBT card

Facility is not kept clean
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Gary Tan conducted an unannounced initial complaint visit at this facility to investigate the above allegations. LPA met with administrator Oscar Chavez and explained the reason for the visit.

LPA conducted physical plant tour at 9:18 AM with the administrator, requested copies of facility documents relevant to the investigation at 10:43 AM and interviewed staff and residents between 11:00 AM to 1:45 PM. Regarding the allegation that the Staff withhold resident's card, it was alleged that Staff #1 (S1) took away residents' EBT card and left them with no money. LPA's interview with six (6) residents today between 11:00 AM to 1:45 PM, revealed that all six (6) of them were never asked by any staff nor withhold any bank card or EBT from them. LPA's interview with S1 today at 11:34 AM revealed that S1 never asked any residents of their bank or EBT Card. LPA's interview with the administrator today at 12:00 PM also revealed that he did not receive any report of S1 withholding or taking any EBT or bank card of any resident.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
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: 08/24/2023
NARRATIVE
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(continued from LIC 9099)

Regarding the allegation that the Facility is not kept clean, it was alleged that the facility has dirt and trash on the floors and underneath the resident's bed. Facility bathrooms also have trash on the floor, not cleaned well and have smell of feces and urine. LPA's observation during today's physical plant tour at 9:18 AM revealed that all the buildings (Building 1 to 5) visited were generally clean and free of odor including their bathrooms. LPA's interview today with six (6) residents or more than 10% of the current census revealed that all six (6) of them stated that their rooms and bathrooms are being cleaned by the housekeeper and caregiver everyday and that they are almost always clean.

Based on the information gathered during this visit. These allegations are deemed unsubstantiated at this time.

Exit interview conducted. Copy of this report issued.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3