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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 425802106
Report Date: 11/19/2025
Date Signed: 11/19/2025 04:42:14 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
11/04/2024 and conducted by Evaluator Rachael De Leon
COMPLAINT CONTROL NUMBER: 29-AS-20241104104759
FACILITY NAME:WESTMONT OF SANTA BARBARAFACILITY NUMBER:
425802106
ADMINISTRATOR:ERNEST "EJ" LEWISFACILITY TYPE:
740
ADDRESS:190 VIAJERO DRTELEPHONE:
(805) 265-4327
CITY:GOLETASTATE: CAZIP CODE:
93117
CAPACITY:99CENSUS: 72DATE:
11/19/2025
UNANNOUNCEDTIME BEGAN:
03:45 PM
MET WITH:Administrator Jade Alma-HarrisTIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Staff are not being properly trained
Staff mishandled a resident's medication
Staff interfered from reporting incidents involving a resident
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) De Leon conducted a subsequent complaint visit to the facility above. LPA met with Administrator Jade Alma-Harris and explained the purpose of the visit.

LPA Kontilis conducted the original 10-day complaint visit to the facility on 11/08/2024, requested records and interviewed staff at 11:21am and 2:38pm. LPA Kontilis conducted additional interviews with witnesses on 11/12/2024 at 12:06pm, 11/13/2024 at 8:47am, and with Administrator on 08/29/2025 at 11:13am.

LPA De Leon reviewed the complaint, interviews and records and conducted further investigation from 11/05/2025-11/19/2025. LPA requested additional records on 11/13/2025 from Administrator, partial records were received.

On the allegation: Staff are not being properly trained, LPA Kontilis requested training records for staff handling medications on 11/08/2024, only emails were provided. Cont. 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
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 5
Control Number 29-AS-20241104104759
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: WESTMONT OF SANTA BARBARA
FACILITY NUMBER: 425802106
VISIT DATE: 11/19/2025
NARRATIVE
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LPA De Leon reviewed the emails which revealed the previous Administrator was setting up medication training for a list of staff handling medications. The email chain did not have set dates for training to be held or completed, and the emails were dated 09/2024. The prior administrator no longer works at the facility as of 11/2024. LPA Kontilis never received staff medication training records during the investigation. LPA De Leon requested 2024 medication training records on 11/13/2025 from the new Administrator as of 10/19/2025 no medication records were produced. Due to the lack of evidence with training records for medication staff this allegation is Substantiated.

On the allegation: Staff mishandled a resident's medication, LPA Kontilis was provided with the facility’s internal investigation report, at the time the investigation was ongoing and had not been completed. LPA De Leon requested the completed investigation report and any staff disciplinary records on 11/13/2025, Administrator provided one staff members disciplinary record which did not involve a medication error. LPA De Leon reviewed the emails, medication records and photos which revealed the Resident 1 (R1) handled and stored R1’s own medications when moving into the facility on 09/27/2024, the medication order was for Amiodarone HCL 200mg – 1 tab by mouth twice a day and was prescribed by R1’s Cardiologist. On 10/09/2024 Staff notes communicate that R1 was having confusion with medications and staff felt it should be centrally stored by the facility. On 10/12/2024 the facility took over R1’s medication and Staff 1 (S1) took a telephone order from another doctor for Amiodarone HCL 400mg – 1 tab by mouth twice a day. The doctor’s office was contacted by the facility during the investigation to ask if the telephone order was correct, the office told the facility that they did not do a phone order for that medication for R1. On 10/22/2024 the cardiologist wrote an order for the medication Amiodarone 200mg – 1 tab by mouth twice a day. The medication Amiodarone 400mg – 1 tab by mouth twice a day was provided to R1 from 10/12/2024 until 10/23/2024. The record keeping of medications and orders was not being done timely and several orders were not confirmed by the prescribing physician which was a communication breakdown between the facility and the providers which is required when the medications for the residents are being centrally stored, and the staff are aiding the residents with taking medications. Residents pay additional fees to have the medication managed by the facility and the lack of communication was the issue with this medication being given. Based on the evidence this allegation is deemed Substantiated at this time.


Continued 9099-C
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 29-AS-20241104104759
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: WESTMONT OF SANTA BARBARA
FACILITY NUMBER: 425802106
VISIT DATE: 11/19/2025
NARRATIVE
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On the allegation: Staff interfered with reporting incidents involving a resident, LPA De Leon reviewed records and interviews which revealed Resident 1 (R1) had medication changes in October which increased the medication dosage. On 10/22/2024 the cardiologist wrote an order for the medication Amiodarone 200mg – 1 tab by mouth twice a day. The medication Amiodarone 400mg – 1 tab by mouth twice a day was provided to R1 from 10/12/2025 until 10/23/2024. The doctor’s office that increased the medication to 400mg was contacted by the facility and the facility was told that doctor did not change the medication by telephone order. Due to the record keeping showing the medication was give at 400mg twice a day and the cardiologist confirmed the medication was to be given at 200mg twice a day, the facility made an error by providing the higher dosage to the resident from 10/12/2024-10/23/2024. CCL did not recieve an incident report for these error therefore based on the evidence this allegation is Substantiated at this time.

Exit interview conducted, Deficiencies cited, copy of report and appeal rights printed for Administrator.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 29-AS-20241104104759
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: WESTMONT OF SANTA BARBARA
FACILITY NUMBER: 425802106
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/26/2025
Section Cited
HSC
1569.69(a)(1)
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(a)...:(1)...the employee shall complete 24 hours of initial training. This training shall consist of 16 hours of hands-on shadowing training,...and 8 hours of other training or instruction,...which shall be completed within the first four weeks of employment. This requirement was not met as evidenced by:
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Administrator agreed to hold training for all staff on H&S code 1569.69 and provide staff missing any of these requirements with medication training, provide proof of training and an up to date LIC 500 with all staff and positions listed to CCL.
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Based on record review the Licensee did not comply with the regulation above staff did not take initial /or annual medication training which possess a potential health, safety and personal rights risk to residents in care.
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Type B
11/26/2025
Section Cited
CCR
87468.2(a)(4)
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(a)...(4)To care, supervision, and services that meet their individual needs and are delivered by staff that are sufficient in numbers, qualifications, and competency to meet their needs. This requirement was not met as evidenced by:
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Administrator agreed to hold personal rights training with all staff to include regulations 87468.1 and 87468.2. Provide proof of training and an up-to-date LIC. 500 for all staff to CCL.
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Based on interviews and records the Licensee did not comply with the regulation above, staff were not competent in handling the centrally stored medications and assistance to residents, without errors which possess a potential health, safety and personal rights risk to residents in care.
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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: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 29-AS-20241104104759
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: WESTMONT OF SANTA BARBARA
FACILITY NUMBER: 425802106
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/26/2025
Section Cited
CCR
87211(a)(1)(D)
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(a)...(1)...(D)Any incident which threatens the welfare, safety or health of any resident, such as psychological abuse of a resident by staff or other residents, or unexplained absence of any resident. This requirement was not met as evidenced by:
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Administrator agreed to train all staff in reporting requirements 87211 and send proof of training with an up to date LIC 500 will all staff to CCL.
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Based on incident reporting the Licensee did not comply with the regulation above The facility did not report any medication errors or discrepancies for R1 which possess a potential Health, safety and personal rights risk to residents in care.
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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: Kelly Burley
LICENSING EVALUATOR NAME: Rachael De Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5