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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610126
Report Date: 06/21/2024
Date Signed: 06/21/2024 02:34:35 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
07/21/2023 and conducted by Evaluator Melissa Spaeth
COMPLAINT CONTROL NUMBER: 31-AS-20230721082907
FACILITY NAME:LAUREL HOMEFACILITY NUMBER:
197610126
ADMINISTRATOR:YOLANDA PICKENSFACILITY TYPE:
737
ADDRESS:41447 W 25TH STREETTELEPHONE:
(661) 947-9612
CITY:PALMDALESTATE: CAZIP CODE:
93551
CAPACITY:4CENSUS: 4DATE:
06/21/2024
UNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Alex EspinozaTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Staff did not provide services to resident as specified in their IPP.
INVESTIGATION FINDINGS:
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On 6/21/2024 Licensing Program Analyst (LPA) Melissa Spaeth conducted a subsequent complaint investigation at the above facility to address the following allegation(s). LPA Spaeth was greeted by the assistant administrator. LPA Spaeth stated the purpose of the visit was present the findings of the investigation and request additional documentation. LPA received relevant documentation from the Assistant Administrator at 9:45 am. LPA Spaeth interviewed the client (C1) at 10:00 am until 10:05 am.

The investigation consisted of the following: On 6/14/2023 LPA Spaeth conducted a physical plant tour and requested documentation.

Continued on 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Melissa Spaeth
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2024
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 2
Control Number 31-AS-20230721082907
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: LAUREL HOME
FACILITY NUMBER: 197610126
VISIT DATE: 06/21/2024
NARRATIVE
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Regarding the allegation, Staff did not provide services to resident as specified in their IPP. It’s being alleged that C1 was not provided license marriage and family therapist consultation services from January, 2023 until June 2023. C1 was interviewed at 10:00 am who stated the therapy sessions were Zoom meetings but C1 did not like the Zoom meetings but preferred in person sessions.

LPA Spaeth interviewed the previous Administrator on 7/23/2023 at 1:00 pm via phone who stated they observed C1 was falling asleep during the April 2023 Zoom meetings. The previous Administrator spoke to C1 and asked if there was an issue with the Zoom meetings. C1 stated they did not like the Zoom meetings and would rather have in person meetings. The Administrator stated they immediately contacted the corporate office April, 2023 and began the process of searching for a new in person therapist.

LPA Spaeth received copies of the consultant log from the therapy sessions for the months of January, 2023 through April 15, 2023 which is proof that C1 did receive the required therapy. LPA also reviewed the North LA County Regional Center’s Monthly Audit meeting notes when the Regional Center staff met with the Administrator and received updates regarding the clients. The meeting notes indicated on March 14, 2023, the Administrator discussed the transition of C1 from the current therapist provider to the newly identified therapist provider. The meeting notes stated the therapy sessions ended on 4/15/2023 and the team was currently working on the finalization of the contract with the new therapist provider. The meeting notes also confirmed on May 2, 2023, the new contract was generated for the new therapist provider. LPA received a copy of the contract which is dated May 4, 2023.

Based upon LPA’s interviews and the review of relevant documentation, the allegation, Staff did not provide services to resident as specified in their IPP is unsubstantiated.

The Assistant Administrator left the facility but confirmed the back-up Administrator could sign the report. Exit interview conducted and a copy of the report was given.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Melissa Spaeth
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2