421700457-8-15-2025-29-AS-KBUY-DL2KWY-20250830081643

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 421700457
Report Date: 08/15/2025
Date Signed: 08/15/2025 03:30:20 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. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/12/2025 and conducted by Evaluator Kristin Kontilis

COMPLAINT CONTROL NUMBER: 29-AS-20250812091303

FACILITY NAME:	WOOD GLEN HALL, INC.		FACILITY NUMBER:	421700457
ADMINISTRATOR:	RICK OLDS		FACILITY TYPE:	740
ADDRESS:	3010 FOOTHILL ROAD		TELEPHONE:	(805) 687-7771
CITY:	SANTA BARBARA	STATE: CA	ZIP CODE:	93105
CAPACITY:	72	CENSUS: 50	DATE:	08/15/2025
		UNANNOUNCED	TIME BEGAN:	11:40 AM
MET WITH:	Rick Olds, Administrator		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff do not ensure resident binders are up to date.
Staff are pre-pouring medications.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kristin Kontilis conducted an unannounced 10-day complaint investigation based on the above stated allegations. LPA met with Administrator Rick Olds and explained the purpose of the visit.
During today’s visit, LPA obtained documents pertaining to the allegation and conducted interviews with staff.
On the allegation, “Staff do not ensure resident binders are up to date”, LPA reviewed resident records for ten (10) residents and found 10 out of 10 residents’ binders to include required documents including but not limited to emergency face sheets, dates of birth, dates of admission, Physician’s report, Resident’s care plan; Pre-Placement Appraisal and/or Re-Appraisal; and Medication Administration Record. Additionally, per facility staff, the facility is in the process of updating resident records to include recommended documents as a suggestion from a residential care consulting agency. The recommended documents are not required

Please continue to 9099-C, Pg 2.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2025

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 29-AS-20250812091303

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: WOOD GLEN HALL, INC.	FACILITY NUMBER: 421700457
	VISIT DATE: 08/15/2025

NARRATIVE

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per Title 22 regulations. Based on records reviewed, interviews conducted, and observations made, the allegation Staff do not ensure resident binders are up to date is Unsubstantiated at this time.

On the allegation, “Staff are pre-pouring medications”, LPA Kontilis reviewed Medication Guide, Residential Care Facilities for the Elderly published by California Department of Social Services, Community Care Licensing Division, Advocacy and Technical Support, Resource Guide, TSP 2016-03 (version 8/30/2021) with administrator and staff. The medication guide specifically states, “Medications may be ‘set up’ or ‘poured’ under the following circumstances…Pour medications from the bottle directly into the individual resident’s cup/utensil to avoid touching or contaminating the medication; implement a process to ensure medication is given to the correct resident; implement procedures for situations such as medication spillage, contamination, assisting with liquid medication, interactions of medications, etc.
During today’s visit, LPA Kontilis interviewed Staff 1 (S1) wherein S1 demonstrated the steps they take when popping medications prior to administering to residents in care. S1’s demonstration included precautions taken such as wearing gloves to ensure no contamination of the medication occurs. LPA observed the medication cups to have the Resident’s name, picture, and room number on each medication cup. S1 further stated if a resident needs assistance at the time of medication administration, S1 will call for additional assistance from a caregiver and/or other staff to assist. S1 stated they have worked in the facility for over a decade and has followed this procedure consistently with no history of medication errors or contaminations.
Based on interviews conducted, records reviewed, and observations made, the allegation that staff are pre-pouring medications is Unsubstantiated at this time.

Exit interview conducted. No deficiencies noted. Copy of report issued at the time of the visit.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:	DATE: 08/15/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2025

LIC9099 (FAS) - (06/04)

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