565801201-6-21-2024-29-AS-KLOZ-D6NTJW-20240628144701

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565801201
Report Date: 06/21/2024
Date Signed: 06/21/2024 05:19:36 PM

Unfounded

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
03/18/2024 and conducted by Evaluator Esther Cortez

COMPLAINT CONTROL NUMBER: 29-AS-20240318082439

FACILITY NAME:	ABSOLUTE CARE HOME		FACILITY NUMBER:	565801201
ADMINISTRATOR:	MARIA LOURDES RICAFORT		FACILITY TYPE:	740
ADDRESS:	1601 KIPLING COURT		TELEPHONE:	(805) 986-8118
CITY:	OXNARD	STATE: CA	ZIP CODE:	93033
CAPACITY:	6	CENSUS: 1	DATE:	06/21/2024
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Maria Lourdes Ricafort		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff did not allow resident visitors.
Staff confiscated resident's cell phone.

INVESTIGATION FINDINGS:

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At 10:30 a.m. Licensing Program Analyst (LPA) Esther Cortez conducted an unannounced subsequent complaint visit. The LPA met with Administrator Maria Lourdes Ricafort and the reason for the visit was explained.

On 03/19/2024 the LPA along with the Administrator toured the facility, interviewed two (2) residents, and one (1) staff between 12:35 p.m and 3:40 p.m., and the LPA also obtained pertinent documents. On 05/21/2024 the LPA toured the facility with staff, and interview one (1) staff. During today's visit the LPA toured the facility with the administrator, obtained pertinent documents, and conducted an interview with the administrator throughout the visit.

Report will continue on on LIC9099-C (2ND PAGE).

Unfounded

Estimated Days of Completion:

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Esther Cortez	TELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:	DATE: 06/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2024

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-20240318082439

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: ABSOLUTE CARE HOME	FACILITY NUMBER: 565801201
	VISIT DATE: 06/21/2024

NARRATIVE

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Regarding allegations: Staff did not allow resident visitors and Staff confiscated resident's cell phone, it is the reporting parties concern that on February 18th, staff #1 (S1) told resident #1's (R1's) visitors, they were not allowed to see the resident and turned them away. It was further reported that S1 confiscated the resident's cell phone. To investigate the allegation the LPA conducted interviews and record review. Interviews conducted and review of roster revealed that the resident in question, whom the complaint is in reference to is a family member of the administrator, who was staying at the facility due to medical reasons and not a client/resident of the facility. Interviews with the administrator revealed that R1 did not have an admission's agreement or was paying money to the facility, and is no longer at the facility. Per the investigation, the allegations are deemed Unfounded at this time. A finding of Unfounded means that the allegations are either false, could not have happened, and/or is without a reasonable basis.

A case management report was issued due to deficiencies found during the investigation. Exit interview. A copy of the report was issued.

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Esther Cortez	TELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:	DATE: 06/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2024

LIC9099 (FAS) - (06/04)

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