561703573-10-3-2023-29-AS-KLOZ-CZZ7W5-20240130210059

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 561703573
Report Date: 10/02/2023
Date Signed: 10/03/2023 10:11:11 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
09/25/2023 and conducted by Evaluator Sandra Urena

COMPLAINT CONTROL NUMBER: 29-AS-20230925123938

FACILITY NAME:	ELMS RESIDENTIAL CARE		FACILITY NUMBER:	561703573
ADMINISTRATOR:	HIGGINS, FE LILIA 98		FACILITY TYPE:	740
ADDRESS:	67 EAST BARNETT		TELEPHONE:	(805) 643-2176
CITY:	VENTURA	STATE: CA	ZIP CODE:	93001
CAPACITY:	54	CENSUS: 44	DATE:	10/02/2023
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Fe Lilia Higgins		TIME COMPLETED:	04:20 PM

ALLEGATION(S):

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Facility has a bedbug infestation.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Sandra Urena conducted an unannounced initial 10-day visit to investigate the allegation described above. The LPA met with Administrator Fe Higgins at 1:30 p.m. and explained the reason for the visit.

At 1:45 the LPA and the administrator conducted a tour of the facility. The LPA conducted residents’ interviews from 1:50 p.m. to 2:54 p.m. At 3:15 p.m. the LPA requested records pertaining to the investigation. At 3:30 p.m. the LPA interviewed the administrator.

Continues on LIC 9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Sandra Urena	TELEPHONE: 747-230-3919
LICENSING EVALUATOR SIGNATURE:	DATE: 10/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2023

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-20230925123938

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: ELMS RESIDENTIAL CARE	FACILITY NUMBER: 561703573
	VISIT DATE: 10/02/2023

NARRATIVE

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On the allegation that the facility has a bedbug infestation, it is the reporting party’s concern that a bedbug infestation was observed by several witnesses. The investigate the allegation, the LPA conducted an inspection of ten (10) facility’s rooms and spoke with residents in each room. Each room inspected was occupied by two residents. The inspection of each room revealed that the mattresses, and mattress spring box have a plastic mattress cover. The LPA inspected the mattresses, and did not observe bedbugs, or signs of bedbug infestation. The interview with residents revealed the following: Eight (8) out of twenty (20) residents expressed that they had experienced bedbugs at the beginning of September 2023, but since then, the mattresses have been replaced with new mattresses, new pillows and all the sheets and bed covers were washed. Additionally, the bedroom furniture was taken out to the patio to be washed and disinfected. The rooms were vacuumed and cleaned thoroughly. Eleven (11) residents expressed that they had not experienced any problems with bed bugs, one (1) resident stated that they did have bedbugs last year but has not experienced any issues since then. Residents stated that an exterminator comes around every month to spray around the dressers, beds, and walls for pest control. Residents were asked if anyone was experiencing bug bites, itching? All residents stated that they were not. The LPA spoke with the pest control company representative and confirmed that the company provides pest control visits every month. The interview with the administrator revealed that they acknowledge that they had a bedbug problem, however the bedbug problem was confined to a couple of rooms and all measures were taken immediately to address the bedbug situation, by replacing mattresses, pillows and calling the exterminator to spray the rooms. The exterminator is conducting monthly bug control by spraying every month.

Although there was a bed bug infestation last month, the inspection and interviews revealed that the bedbug infestation was addressed in a timely manner by the facility. Furthermore, at the time of the inspection, the LPA did not observe bedbugs. Therefore, the allegation is deemed Unsubstantiated at this time.

Exit interview was conducted and report was issued.

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Sandra Urena	TELEPHONE: 747-230-3919
LICENSING EVALUATOR SIGNATURE:	DATE: 10/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2023

LIC9099 (FAS) - (06/04)

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