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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610376
Report Date: 03/26/2024
Date Signed: 03/26/2024 03:30:57 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.RO, 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
02/14/2024 and conducted by Evaluator Leslie Ngo-Castaneda
COMPLAINT CONTROL NUMBER: 31-AS-20240214134709
FACILITY NAME:LIFESYNC MALIBUFACILITY NUMBER:
197610376
ADMINISTRATOR:O'HOP, RYELYFACILITY TYPE:
772
ADDRESS:6231 MURPHY WAYTELEPHONE:
(310) 951-6340
CITY:MALIBUSTATE: CAZIP CODE:
90265
CAPACITY:6CENSUS: 3DATE:
03/26/2024
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Ryely Ohop- AdministratorTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff did not ensure hazardous item was made inaccessible to resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Leslie Ngo-Castaneda conducted a subsequent complaint visit to conclude the above allegation. The initial visit was made on 2.20.2024 during the course of the investigation, it was revealed that there were three (3) clients living in the facility today 3.26.2024. Since then, Resident 1 (R1) was reported to have move back home to Texas. LPA conducted a physical plant walk through, at 2PM, to ensure that the facility is in compliance with rules and regulations under California Code of Regulations, Title 22, Division 6. LPA did not observe any immediate health and safety issues during the visit.

Allegation: Staff did not ensure hazardous item was made inaccessible to resident.

During the physical plant tour on 02.20.2024 and today 3.26.2024 2:00 PM, LPA did not observe any hazardous items left accessible to residents in care. LPA toured storage of toxins and sharps which was observed to be locked an inaccessible to residents in care.
Conitnue to LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:

DATE: 03/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2024
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-20240214134709
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: LIFESYNC MALIBU
FACILITY NUMBER: 197610376
VISIT DATE: 03/26/2024
NARRATIVE
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Interview with six (6) out of six (6) staff reveal that toxins, sharps, and hazardous items are always locked and when an item is needed the item is retrieved and the toxins are immediately locked. Interview with two (2) out of three (3) residents revealed that no hazardous objects are seen or accessible during their stay at the facility. Based on observations and interviews, although the allegation may have happened or is valid, there is insufficient evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Leslie Ngo-Castaneda
LICENSING EVALUATOR SIGNATURE:

DATE: 03/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2024
LIC9099 (FAS) - (06/04)
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