197610121-4-16-2024-31-AS-RORN-D5HKUS-20240522081310

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610121
Report Date: 04/16/2024
Date Signed: 04/16/2024 11:07:49 AM

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
07/06/2022 and conducted by Evaluator Tuesday Cabiness

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20220706113627

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: 48	DATE:	04/16/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Chris Salvador		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Financial abuse

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tuesday Cabiness conducted a subsequent visit and met with Director of Operations Chris Salvador and informed him the reason of the visit. The reason of the visit was to deliver the final findings of the allegation mentioned above. The following was determined.

It was alleged that staff financially abused a resident. On 07/07/2022, from 10am to 230pm, LPA conducted the initial visit, obtained documents pertaining to the allegation, and conducted interviews. During today’s visit, LPA obtained additional documents and interviewed staff. From the information obtained, resident # 1 (R1) complained to Administration that (R1) was not receiving (R1’s) money from staff. Upon the facility’s internal investigation, it was revealed to LPA, that (R1) gave staff (R1’) s debit card and pin number to withdraw funds from (R1’s) account. It was alleged staff was not providing receipts of the withdrawals, nor was staff giving the money to (R1). Once (R1) began complaining, and documentation revealed that there was an excessive amount of money being withdrawn, Administration interviewed the staff, who denied keeping the funds. Administration contacted the police and Licensing to report potential financial abuse. The local police

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) -596-4334
LICENSING EVALUATOR NAME: Tuesday Cabiness	TELEPHONE: (818) 299-4975
LICENSING EVALUATOR SIGNATURE:	DATE: 04/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2024

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-20220706113627

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: WEST HILLS ASSISTED LIVING	FACILITY NUMBER: 197610121
	VISIT DATE: 04/16/2024

NARRATIVE

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department also interviewed staff and (R1), but because (R1) gave the consent and pin to staff to withdraw money, there was no further action taken. Administration conducted a room search of (R1), and staff found over $4000 in the drawer of (R1). Staff denied to LPA and Administrators, taking R1's funds. Although, (R1’) money was found and returned to (R1), there is insufficient evidence, due to (R1) providing the personal banking information to staff. Therefore, based on documentation of records, and interviews, the allegation is Unsubstantiated at this time.

Exit interview and copy of report provided.

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) -596-4334
LICENSING EVALUATOR NAME: Tuesday Cabiness	TELEPHONE: (818) 299-4975
LICENSING EVALUATOR SIGNATURE:	DATE: 04/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2024

LIC9099 (FAS) - (06/04)

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