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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 425802136
Report Date: 02/07/2024
Date Signed: 02/07/2024 05:41:29 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
01/11/2024 and conducted by Evaluator Jeannette Olson
COMPLAINT CONTROL NUMBER: 29-AS-20240111153337
FACILITY NAME:TELECARE CARMEN LANEFACILITY NUMBER:
425802136
ADMINISTRATOR:JESSICA GEIHSFACILITY TYPE:
772
ADDRESS:212 WEST CARMEN LANE STE 201TELEPHONE:
(805) 212-7680
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY:12CENSUS: 11DATE:
02/07/2024
UNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Lindsay Cunningham, Interim Regional Director of OperationsTIME COMPLETED:
05:55 PM
ALLEGATION(S):
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9
Staff do not treat clients with dignity
Staff is denying the clients access to food
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Olson conducted a subsequent complaint visit to deliver final findings for the above allegations. LPA Olson interviewed Staff on 1/18/24, 2/6/24, and 2/7/24, Clients and Clinical Director on 1/18/24 and requested relevant documents. During today’s visit, LPA met with Interim Regional Director of Operations and explained the reason for the visit.

On the allegation: Staff do not treat clients with dignity. It was alleged that Staff 1 (S1) yells at clients, treats them as if they are better and more powerful then them and bullies, yells and belittles coworkers in front of clients. Reporting party states S1 is unprofessional and uncompassionate. LPA interviewed clients who stated staff are pretty good and treat them with dignity. One client said sometimes staff’s tone gets rude or they say things that triggers clients and told LPA about a situation between a staff and client. LPA interviewed that client who said it wasn’t a big problem and staff are pretty good, it was just a personality difference.
Continued on 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Jeannette Olson
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
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 5
Control Number 29-AS-20240111153337
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: TELECARE CARMEN LANE
FACILITY NUMBER: 425802136
VISIT DATE: 02/07/2024
NARRATIVE
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Another client said the night staff give them a hard time and say they are “up all night” and are “making too much noise” when they get up to go to the restroom. LPA interviewed staff and asked if there were any staff that don’t treat clients with dignity. One staff stated Staff 2 (S2) would tell staff “(C2) (First name) Mother F$#%ing (Last name) is here again.” Another staff said S1 was “snarky” got in a “verbal scuffle” with a client, is “standoffish” and gives staff the silent treatment often. Interviews revealed C1 and C2 were spoken to poorly, but LPA was unable to reach both C1 and C2, who had since moved out and did not respond to contact attempts. Based on the information obtained the allegation is deemed Substantiated at this time.

On the allegation: Staff is denying the clients access to food. It was alleged that Staff 1 (S1) refuses to give clients a snack after dinner because the kitchen is closed. LPA interviewed clients that stated when they ask for a snack or food they get it. One client said they were denied a snack after 10pm because the kitchen was closed. LPA interviewed staff about anyone who denied clients food/snacks. One staff stated during Christmas a staff wouldn’t give clients seconds because they were saving the extras for tomorrows dinner. LPA interviewed Clinical Director who stated meal times are 7-8am, 11-12pm, and 5-6pm. Snacks are available all day and staff leave fruit and juice out overnight. The kitchen closes at 8pm meaning clients can’t have yogurt or refrigerated items after 8pm. On 1/23/24 the Facility held an all staff meeting and informed staff that clients need to have access to food at all times, the kitchen doesn't close and the restriction signs were removed. Based on the information obtained, the allegation is deemed Substantiated.

Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (LIC 9099-D).

Exit interview conducted, copy of report and appeal rights issued.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Jeannette Olson
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
01/11/2024 and conducted by Evaluator Jeannette Olson
COMPLAINT CONTROL NUMBER: 29-AS-20240111153337

FACILITY NAME:TELECARE CARMEN LANEFACILITY NUMBER:
425802136
ADMINISTRATOR:JESSICA GEIHSFACILITY TYPE:
772
ADDRESS:212 WEST CARMEN LANE STE 201TELEPHONE:
(805) 212-7680
CITY:SANTA MARIASTATE: CAZIP CODE:
93458
CAPACITY:12CENSUS: 11DATE:
02/07/2024
UNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Lindsay Cunningham, Interim Regional Director of OperationsTIME COMPLETED:
05:55 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not safeguard the clients personal belongings
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Olson conducted a subsequent complaint visit to deliver final findings for the above allegation. LPA Olson interviewed Staff on 1/18/24, 2/6/24, and 2/7/24, Clients and Clinical Director on 1/18/24 and requested relevant documents. During today’s visit, LPA met with Interim Regional Director of Operations and explained the reason for the visit.

On the allegation: Staff does not safeguard the clients personal belongings. It was alleged that Staff 1 refuses to inventory new client’s personal belongings that come in on their shift and once left a clients personal belongings in the hallway all night and refused to put them in a locked room. LPA interviewed clients who stated they have not had any issues with staff locking up or inventorying their personal property. Multiple staff revealed C3 had a suitcase come in, but it sat in the “hub” or nurses station for 2 full days. Staff stated another staff refused to inventory it because the policy is for the staff who was on shift at the time it came in to inventory it.
Continued on 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Jeannette Olson
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 29-AS-20240111153337
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: TELECARE CARMEN LANE
FACILITY NUMBER: 425802136
VISIT DATE: 02/07/2024
NARRATIVE
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When Clinical Director was interviewed they stated they were not really aware of the suitcase not being inventoried but heard there was a client who was too tired to do inventory so it was done the next day. Director stated the policy is to process the client’s property same day with the staff that received their items. During the investigation, no items were found to have gone missing due to staff not following the policy. Based on the information obtained the allegation is deemed Unsubstantiated. Technical Assistance is issued to remind facility staff to follow policies to safeguard client’s personal belongings. Administrator stated this topic was discussed during the all staff meeting on 1/23/24.

Exit interview conducted, copy of report issued.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Jeannette Olson
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 29-AS-20240111153337
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: TELECARE CARMEN LANE
FACILITY NUMBER: 425802136
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/07/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/09/2024
Section Cited
CCR
81072(a)(1)
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81072 PERSONAL RIGHTS (a) Each client shall have personal rights which include, but are not limited to, the following: (1) To be accorded dignity in his/her personal relationships with staff and other persons.
This requirement was not met as evidenced by:
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Administrator agreed to submit a plan to CCL by 2/9/24 on how the facility will train all staff on personal rights.
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Based on interviews, the licensee did not comply with the section cited above when facility staff did not treat clients with dignity, which posed an immediate personal rights violation to persons in care.
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Type B
02/21/2024
Section Cited
CCR
81076(a)(4)
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81076 FOOD SERVICE (a) In a social rehabilitation facility providing meals to clients, the following shall apply: (4) Between meal nourishment or snacks shall be available for all clients unless limited by dietary restrictions...This requirement was not
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Administrator agreed to have staff sign an acknowledgement for clients food availability and submit to CCL by 2/21/24
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met as evidenced by:
Based on interviews, the licensee did not comply with the section cited above when facility staff did give snacks to clients when requested, which posed a potential personal rights violation to persons 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: Jeannette Olson
LICENSING EVALUATOR SIGNATURE:

DATE: 02/07/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5