<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197690039
Report Date: 10/19/2022
Date Signed: 10/19/2022 02:58:32 PM

Substantiated


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. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/13/2020 and conducted by Evaluator Kasandra Lopez
COMPLAINT CONTROL NUMBER: 29-AS-20201113093758
FACILITY NAME:LA VENTANA TREATMENT PROGRAMSFACILITY NUMBER:
197690039
ADMINISTRATOR:DIAHANN KLEINFACILITY TYPE:
772
ADDRESS:779 BRIAR CLIFF ROADTELEPHONE:
(805) 371-1274
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91360
CAPACITY:6CENSUS: 5DATE:
10/19/2022
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Jennifer Enriquez,TIME COMPLETED:
02:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility operating over capacity
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) KaSandra Lopez conducted an unannounced subsequent complaint visit regarding the above allegation. The LPA met with Program Director Jennifer Enriquez and explained the reason for the inspection. Licensee Representative Steve Zamarripa and Director of Nursing Wendy McCain arrived shortly after the inspection began.

On 11/16/2020 at 3:18 PM, LPA Lopez and LPA Morgan initiated this investigation telephonically with Licensee Representative Steve Zamarripa. At 3:57 PM, LPA Lopez and LPA Morgan conducted a video call via face time at the facility with Sharon Volner, Chief Clinical Officer and Wendy McCain, Director of Nursing. At 4:01 PM, a physical plant tour of the facility was conducted.

During today's visit at 11:07 AM, the LPA and Ms. Enriquez conducted a physical plant tour of the facility. The LPA observed three client bedroom, the common areas including a group room, garage, and outside area.
Report continued on LIC 9099-C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Kasandra Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
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 4
Control Number 29-AS-20201113093758
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. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: LA VENTANA TREATMENT PROGRAMS
FACILITY NUMBER: 197690039
VISIT DATE: 10/19/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Ms. Enriquez stated the facility used to have an isolation room but the room has now been converted to the group room. She stated if in the event an isolation room is needed, the group room could be utilized. The LPA then met with Ms. Enriquez, Ms. McCain, and Mr. Zamarripa in the office and reviewed medications and medication records. The LPA also interviewed Staff #1 (S1) at 12:21 PM.

The allegation of 'Facility operating over capacity' alleged on several occasions during the months of September 2020 through October 2020, the facility's isolation room was used to house a 7th client.
On 11/19/2020, Mr. Zamarripa's submitted a written response to the allegations which stated the facility's isolation room had been used to separate a potential client from the milieu until they received Covid test results which may have resulted in seven people in the facility but only for a day or two and only six are programming per their licensing requirements. However, the facility is licensed for up to six clients only. During today's visit, the LPA discussed the written response with Mr. Zamarripa and he understands he can only have up to six clients total residing in the home at all times.

Based on the information obtained, there is sufficient evidence to support the claim that the facility operated over capacity. This allegation is deemed Substantiated at this time.
Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 9099-D). Exit interview conducted, today's reports and appeal rights were reviewed with Ms. Enriquez and Ms. McCain and the report was emailed. Civil penalty assessed for zero tolerance violation.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Kasandra Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 29-AS-20201113093758
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. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: LA VENTANA TREATMENT PROGRAMS
FACILITY NUMBER: 197690039
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/19/2022
Section Cited
CCR
81010(a)
1
2
3
4
5
6
7
81010 Limitations on Capacity and Ambulatory Status (a) A licensee shall not operate a facility beyond the conditions and limitations specified on the license, including the capacity limitation.
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
The Licensee Representative agreed to do the following:
Submit a Statement of Understanding, detailing how the facility will maintain compliance as it relates to capacity limitation. This shall be submitted to CCL by 11/24/2022.
8
9
10
11
12
13
14
Based on interview and written statement, the licensee failed to comply with the section cited above as the facility was over capacity which poses an immediate threat to the health, safety, and personal rights of clients in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Kasandra Lopez
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4