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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565801201
Report Date: 11/14/2024
Date Signed: 11/14/2024 11:05:24 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
11/08/2024 and conducted by Evaluator Emily Peraldi
COMPLAINT CONTROL NUMBER: 29-AS-20241108150116
FACILITY NAME:ABSOLUTE CARE HOMEFACILITY NUMBER:
565801201
ADMINISTRATOR:MARIA LOURDES RICAFORTFACILITY TYPE:
740
ADDRESS:1601 KIPLING COURTTELEPHONE:
(805) 986-8118
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:6CENSUS: 2DATE:
11/14/2024
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Maria Lourdes Picafort, Administrator TIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Staff didn't ensure chemicals were locked making them accessible to residents in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Emily Peraldi conducted an unannounced initial complaint visit to this facility. At 9:40 a.m., the LPA met with staff and explained the reason for the visit. At 9:50 a.m., the Administrator, Maria Lourdes Picafort arrived at the facility.

Between 9:55 a.m. and 10:30 a.m., the LPA conducted interviews with the Administrator, one (1) staff and one (1) resident. At 10:00 a.m., the LPA along with the Administrator conducted a physical plant tour.

Continued on LIC 9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024
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 2
Control Number 29-AS-20241108150116
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: 11/14/2024
NARRATIVE
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Regarding the allegation: 1.) Staff didn't ensure chemicals were locked making them accessible to residents in care. On 11/08/2024, the Department received a complaint regarding chemicals being left unsecured under the kitchen sink. During today’s visit, the LPA observed the cabinet underneath the kitchen sink secured with a child lock. The Administrator explained that underneath the kitchen sink, she only keeps diluted solutions of vinegar and alcohol. The LPA observed two (2) bottles of diluted vinegar and one (1) bottle of alcohol underneath the kitchen sink. The Administrator explained that cleaning supplies and chemicals are kept secured in the locked garage. The LPA observed the garage and confirmed chemicals are stored near the laundry units. The LPA had a conversation with the Administrator about the importance of ensuring all chemicals, including cleaning supplies are kept locked and inaccessible to residents in care. The information obtained during the investigation did not include evidence sufficient to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed Unsubstantiated at this time.

Exit interview conducted. A copy of the report was issued.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Emily Peraldi
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2