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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565800682
Report Date: 08/06/2026
Date Signed: 08/06/2026 12:33:53 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
08/04/2026 and conducted by Evaluator Martha Arroyo
COMPLAINT CONTROL NUMBER: 29-AS-20260804111544
FACILITY NAME:ALMAVIA OF CAMARILLOFACILITY NUMBER:
565800682
ADMINISTRATOR:MICHELE JOHNSONFACILITY TYPE:
740
ADDRESS:2500 NORTH PONDEROSA DRIVETELEPHONE:
(805) 388-5277
CITY:CAMARILLOSTATE: CAZIP CODE:
93010
CAPACITY:100CENSUS: 57DATE:
08/06/2026
UNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Michele JohnsonTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Staff do not ensure residents have TB test results prior to admission
Staff do not ensure that resident appraisals/care plans are being completed
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Martha Arroyo conducted an unannounced initial complaint visit to investigate the allegations noted above. Upon arrival, the LPA was greeted by the front desk concierge and shortly after met with Executive Director (ED), Michele Johnson and the reason for the visit was explained. Entrance interview.

During today's visit, between 09:30 a.m. and 11:45 a.m., the LPA interviewed the ED, conducted a resident file review of five (5) newly admitted residents, and obtained copies of pertinent documents relevant to the investigation.

Report Continued on LIC 9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2026
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-20260804111544
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: ALMAVIA OF CAMARILLO
FACILITY NUMBER: 565800682
VISIT DATE: 08/06/2026
NARRATIVE
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Report Continued from LIC 9099...

It was alleged that staff do not ensure residents have TB test results prior to admission. It is the complainant’s concern that residents are being admitted to the facility before receiving a negative TB test result. Record review of five (5) newly admitted residents revealed that all five residents had undergone TB testing prior to admission to the facility. The LPA reviewed each resident's file and verified documentation of a negative TB test result. An interview with the ED confirmed that all residents are required to obtain a negative TB test result before admission and is a requirement for acceptance into the facility. Based on the information obtained and reviewed, the Department has insufficient evidence to support the allegation of “staff do not ensure residents have TB test results prior to admission”. Therefore, this allegation is deemed Unsubstantiated at this time.

It was also alleged that staff do not ensure that resident appraisals/care plans are being completed. It is the complainant’s concern that residents are not being properly assessed and may not be receiving the care they need. Record review of five (5) newly admitted residents revealed that each resident received a pre-admission appraisal prior to admission to the facility. In addition, the facility conducted an interview with each resident and developed an individualized service plan that identifies the resident's care needs and outlines how the facility will meet those needs. An interview with the ED confirmed that an appraisal and individualized care plan are completed for each resident and maintained in the resident's chart, which is stored in the medication technician's office. The ED further stated that all care staff have access to residents' files and may review each resident's care plan as needed to ensure appropriate care is provided. The care plan is reviewed and updated at least once every six (6) months to ensure its accuracy and reflect the resident's current care needs. Based on the information obtained and reviewed, the Department has insufficient evidence to support the allegation of “staff do not ensure that resident appraisals/care plan is being completed”. Therefore, this allegation is deemed Unsubstantiated at this time.

Exit interview. No citations issued. A copy of the report was provided.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2026
LIC9099 (FAS) - (06/04)
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