197610121-8-2-2022-31-AS-NMAN-CUHVQ3-20230808163741

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610121
Report Date: 08/02/2022
Date Signed: 08/02/2022 05:07:35 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
07/26/2022 and conducted by Evaluator Nicholas Reed

COMPLAINT CONTROL NUMBER: 31-AS-20220726084409

FACILITY NAME:	WEST HILLS ASSISTED LIVING		FACILITY NUMBER:	197610121
ADMINISTRATOR:	MILLAN, JONATHAN		FACILITY TYPE:	740
ADDRESS:	7055 SHOUP AVENUE		TELEPHONE:	(818) 883-7201
CITY:	WEST HILLS	STATE: CA	ZIP CODE:	91307
CAPACITY:	90	CENSUS: 55	DATE:	08/02/2022
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Chris Salvador		TIME COMPLETED:	05:20 PM

ALLEGATION(S):

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Facility did not provide financial assistance to the resident
Staff did not provide wheelchair assistance to the resident
Staff speak inappropriately to a resident
Staff do not ensure safe and healthful living accommodations by providing as needed assistance to resident in care

INVESTIGATION FINDINGS:

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At 10:15 a.m. on 08/02/2022 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with staff and later Administrator and explained the purpose for the visit.
From 10:30 a.m. to 12:30 p.m. LPA interviewed staff and Administrator. LPA conducted a records review at 12:30 p.m. At 12:45 p.m. LPA conducted a physical plant tour to ensure no immediate health and safety issues. LPA did not observe any health and safety issues.
Facility did not provide financial assistance to the resident
Regarding the allegation above, it was alleged the facility has not assisted Resident #1 (R1) in paying R1’s rent. From interviews, R1 is enrolled in Social Security and the Assisted Living Waiver Program. The Social Security check is approximately $15 less than the monthly rent. R1 does not want to pay the difference “on principle”. Staff #1 (S1) stated the facility has offered assistance, but R1 is unwilling to accept the help. Based on interviews 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.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Nicholas Reed	TELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022

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-20220726084409

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: WEST HILLS ASSISTED LIVING	FACILITY NUMBER: 197610121
	VISIT DATE: 08/02/2022

NARRATIVE

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Staff did not provide wheelchair assistance to the resident
Regarding the allegation above, it was alleged that staff do not help push R1’s wheelchair as needed. From interviews, S1 has witnessed R1 move independently with both a cane and a wheelchair. From observation, R1 used a cane independently on 08/02/2022 at 1:45 p.m. From record review, R1 requires “limited assistance” with mobility. The facility planned to “encourage [R1] to use all assistive devices” and “supervise and assist participant as needed” Based on observation, record review, and interview, 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.

Staff speak inappropriately to a resident
Regarding the allegation above, it was alleged S1 spoke aggressively to R1 during an incident on 07/01/2022 around 12:45 p.m. From interviews, S1 and S2 confirmed that the incident involved speech with high volume, but S1 was not aggressive. Based on interviews, 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.

Staff do not ensure safe and healthful living accommodations by providing as needed assistance to resident in care
Regarding the allegation above, it was alleged the facility did not accommodate R1 in a first floor apartment as promised. From interviews, R1 stated they had a verbal agreement with the previous administrator that staff would either push R1 down to the cafeteria or bring meals to R1’s room. S1 offered two consecutive meal deliveries to R1’s room. S1 explained further meal deliveries would come at an additional charge. S1 has offered R1 three different roommates who R1 refused. S1 also confirmed other residents with wheelchairs and walkers live on the second floor. From observation, R1 was placed in a room on the second floor closest to the elevator. Based on interviews and observations, 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. Copy of report provided.

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Nicholas Reed	TELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022

LIC9099 (FAS) - (06/04)

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