425801937-9-25-2024-29-AS-KBUY-D9LRRB-20240930131451

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 425801937
Report Date: 09/25/2024
Date Signed: 09/25/2024 03:42:44 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
07/11/2024 and conducted by Evaluator Kristin Kontilis

COMPLAINT CONTROL NUMBER: 29-AS-20240711102809

FACILITY NAME:	MARAVILLA		FACILITY NUMBER:	425801937
ADMINISTRATOR:	GRANDE, RUTH E		FACILITY TYPE:	740
ADDRESS:	5486 CALLE REAL		TELEPHONE:	(805) 967-1965
CITY:	SANTA BARBARA	STATE: CA	ZIP CODE:	93111
CAPACITY:	131	CENSUS: 121	DATE:	09/25/2024
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Ruth Grande, Executive Director		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Staff did not safeguard resident's personal belongings.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kristin Kontilis conducted a subsequent complaint visit to issue final findings. During today’s visit, LPA met with Ruth Grande, Executive Director and explained the reason for the visit. LPA initiated the investigation on 7/15/2024 from 12:28pm to 4:30pm. During the visit, LPA toured the facility, interviewed staff and residents, and obtained relevant documents. LPA also conducted additional interviews by phone on 7/29/2024 and 7/30/2024.
On the allegation: Staff did not safeguard resident's personal belongings. It was alleged some of Resident 1 (R1)’s jewelry went missing from their room while R1 was in the hospital. R1 went to the hospital on 6/21/2024 and returned on 7/5/2024. R1 resides in the assisted living portion of the facility and does not have a diagnosis of dementia per their physician’s report. When R1 returned to their room on 7/5/2024, they went to their jewelry box to put their watch away and found a total of 11 items were missing, comprised of gold chains and rings including their wedding band. R1 stated all their “best jewelry” was gone, including rings that were kept on one side of the drawer. Additionally, there was approximately $400 in cash in an
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Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024

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-20240711102809

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: MARAVILLA	FACILITY NUMBER: 425801937
	VISIT DATE: 09/25/2024

NARRATIVE

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envelope missing from the same drawer. R1 stated the cash consisted of $20s, $10s, and $5s. R1 showed LPA where they kept each piece of jewelry, and LPA noted R1 was very meticulous and detailed in how they kept the jewelry, with each item having a specific place. R1 searched the entire room for the pieces but found none. R1’s private caregiver called the local police to report the theft. Staff were informed of the missing items.
The private caregiver has worked for R1 for approximately one and a half years, and assisted R1 privately at home before R1 moved into the facility. Private caregiver stated they knew where R1 kept their jewelry, and they often helped R1 put the jewelry away. Private caregiver stated R1 was “extremely picky” about where the items were put and every item had a specific space, and R1 watches everyone closely. Private caregiver stated they helped R1 search their entire room for the jewelry but didn’t find it. Private caregiver described the experience as “traumatic” and stated R1 knows where they put things.
Private caregiver indicated while R1 was at the hospital, they went to R1’s room around 6/22/2024 to put some of R1’s belongings back in their room for safekeeping, such as a wheelchair, handbag, and clothes. Private caregiver stated they went back to the apartment a second time to gather some items for the resident, such as face lotion and glasses. Private caregiver stated they do not remember the exact day but signed into the guest book. When the private caregiver went back to the apartment, they noticed “small movements” of items in the room. Private caregiver stated the wheelchair had been left in the living room, but was now in the closet, and the curtains were partially open as well as the window. There was also mail was put on R1’s desk. They believed it could have been due to housekeeping or laundry service but were confident someone else had been in the room. Private caregiver corrected the items that had moved “because [R1] is so picky.” Private caregiver stated they went back to the room two more times while the resident was in the hospital, and “each time something was different,” such as the windows and/or curtains open, a door was open, and R1’s plants were outside. R1’s family member also stated the private caregiver informed them of this same information directly and gave a very similar account of the items moved around and jewelry missing.
Staff interviewed also noted another resident lost a $100 bill around the same time R1 was in the hospital. Additionally, one staff interviewed indicated an incident where R1 said Staff 1 (S1), who had been working double shifts, was sleeping in R1’s room on their sofa during their shift. S1 later “joked” to R1 that R1 should have given S1 “something for free, something expensive” from R1’s yard sale.

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SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20240711102809

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: MARAVILLA	FACILITY NUMBER: 425801937
	VISIT DATE: 09/25/2024

NARRATIVE

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Administrator stated R1’s room was kept locked and housekeeping typically cleaned R1’s room on Mondays. Administrator stated R1’s room was cleaned on 6/24/2024 by staff and the room was not cleaned again prior to R1 returning from the hospital. Law enforcement was contacted in regards to the missing items but has not charged anyone with a crime as of yet. At this time, there is insufficient evidence to prove who took the missing jewelry or where it went, and there was insufficient evidence to prove it was a facility staff. Therefore the allegation is deemed Unsubstantiated at this time. If further evidence is brought forward, this case may be reopened.

Exit interview conducted. Copy of report issued at the time of the visit.

SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Kristin Kontilis
LICENSING EVALUATOR SIGNATURE:	DATE: 09/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024

LIC9099 (FAS) - (06/04)

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