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Department of
SOCIAL SERVICES
Community Care Licensing
COMPLAINT INVESTIGATION REPORT
Facility Number:
197610147
Report Date:
11/01/2022
Date Signed:
11/01/2022 06:23:42 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
10/25/2022
and conducted by Evaluator
Wendell Smith
COMPLAINT CONTROL NUMBER:
31-AS-20221025113659
FACILITY NAME:
HOME CARE OF WEST HILLS #2 LLC
FACILITY NUMBER:
197610147
ADMINISTRATOR:
CAPATAYAN, GLENN R.
FACILITY TYPE:
740
ADDRESS:
22523 SCHOOLCRAFT STREET
TELEPHONE:
(818) 932-0079
CITY:
WEST HILLS
STATE:
CA
ZIP CODE:
91307
CAPACITY:
6
CENSUS:
5
DATE:
11/01/2022
UNANNOUNCED
TIME BEGAN:
10:45 AM
MET WITH:
Joanne Getela
TIME COMPLETED:
01:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff refusing to allow resident to have visitor(s).
Staff not allowing resident to speak with family.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Wendell Smith conducted an unannounced complaint visit to investigate the allegations above. LPA met with facility staff and explained the reason for this visit.
LPA conducted a physical plant walk through to ensure no immediate health and safety issues and none were noted.
Regarding the allegations above it is alleged that staff are not allowing resident #1 (R1) to have visitors or R1 is not allowed to speak with their family. LPA conducted interviews with residents from 11:30-11:45am. LPA also reviewed facility files from 11-11:30am. Information obtained from interviews and observation show that R1 is not a resident of this facility and has not resided in this facility for sometime. This facility was licensed as of 4/19/21 due to a change of ownership. The previous owner of this facility was familiar with R1 but it is believed that R1 left the facility when it was re-licensed on 4/19/21 under the current ownership. LPA has attempted to contact the previous owner before this facility was licensed but has not been able to reach them. Based on the information obtained both of these allegations are deemed Unsubstantiated at this time.
Exit Interview conducted.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME
:
Cassandra Harris
LICENSING EVALUATOR NAME
:
Wendell Smith
LICENSING EVALUATOR SIGNATURE
:
DATE:
11/01/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
11/01/2022
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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