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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 425850084
Report Date: 01/15/2025
Date Signed: 01/15/2025 10:56:36 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 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
01/02/2025 and conducted by Evaluator Erika Miller
COMPLAINT CONTROL NUMBER: 29-AS-20250102164242
FACILITY NAME:DEVEREUX CALIFORNIA - TULAROSAFACILITY NUMBER:
425850084
ADMINISTRATOR:PATTON, CHRISTOPHERFACILITY TYPE:
737
ADDRESS:1855 TULAROSA ROADTELEPHONE:
(805) 879-0357
CITY:LOMPOCSTATE: CAZIP CODE:
93436
CAPACITY:3CENSUS: 3DATE:
01/15/2025
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Lizeth Aguilar, Back Up AdministratorTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff are not allowing a resident in care to receive phone calls
Staff are not allowing a resident in care to have visitors
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Erika Miller (Miller) conducted an unannounced subsequent complaint visit to issue final findings on the allegations above. LPA Miller collaborated with Tri-Counties Regional Center (TCRC) Quality Assurance Specialist (QAS) Stephanie Cole. LPA met with back- up Administrator and explained the purpose of the visit.

On the allegation: Staff are not allowing a resident in care to receive phone calls and staff are not allowing a resident in care to have visitors. Administrator refutes the allegations in their entirety. 3 of 3 residents at the facility are under a conservatorship. TCRC provided a copy of the Visitation and Communication Guidelines effective February 2024 that apply to R1. Christopher Patton, Administrator and facility staff stated they adhere to the guidelines provided by conservatorship and follow the recommendations of resident physicians.

(Continued on 809-C)


Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Erika Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025
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 2
Control Number 29-AS-20250102164242
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: DEVEREUX CALIFORNIA - TULAROSA
FACILITY NUMBER: 425850084
VISIT DATE: 01/15/2025
NARRATIVE
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Staff interviewed stated that facility does not prevent calls or visitors unless there is a restriction through conservatorship. Staff have never observed staff turn away visitors or terminate calls. A staff member further added that only the conservatorship (TCRC) can terminate phone calls.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegations are Unsubstantiated.

An Exit interview conducted, and a copy of this report issued.
SUPERVISORS NAME: Kelly Burley
LICENSING EVALUATOR NAME: Erika Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 01/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/15/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2