565801300-11-15-2024-29-AS-DPEA-DBCUWK-20241125145653

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565801300
Report Date: 11/07/2024
Date Signed: 11/15/2024 03:13:37 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
12/12/2023 and conducted by Evaluator Zabel Chochian

COMPLAINT CONTROL NUMBER: 29-AS-20231212123032

FACILITY NAME:	HOME SWEET HOME CARE		FACILITY NUMBER:	565801300
ADMINISTRATOR:	GLORIA P. VALENCIA		FACILITY TYPE:	740
ADDRESS:	7520 VAN BUREN STREET		TELEPHONE:	(805) 659-4427
CITY:	VENTURA	STATE: CA	ZIP CODE:	93003
CAPACITY:	0	CENSUS: 0	DATE:	11/07/2024
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Gloria Valencia		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff are not adhering to personal hygiene and food services sanitation practices.
Staff are not maintaining a comfortable temperature for resident while in care.
Staff are arguing in the presence of residents in care.
Staff do not ensure that resident is able to engage in their prescribed physical therapy exercises.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Z. Chochian contacted Licensee Gloria Valencia today and discussed the above allegation findings. LPA delivered final findings for the above allegations via email and certified mail, since the facility closed due to a change of ownership effective 04/16/2024. Ms. Valencia agreed to sign and return report by email or fax and also mail original signed report to LPA by 11/14/2024.

On 12/12/2023, Community Care Licensing Division received the above complaint allegations. Information was provided that staff don't seem to follow food sanitation practices; staff prepare, handle, and serve food with their fingers and do not wash their hands. It was also reported that staff leave cooked meat out on the counters for a long time. Also, it was reported that staff keep the bedroom window in resident's room open all night and it is extremely cold. In addition, it was reported that two female staff members argue in front of the residents all the time which makes residents feel very uncomfortable. Furthermore, it was reported that staff do not ensure resident engage in their prescribed physical therapy exercises.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Zabel Chochian	TELEPHONE: (818) 419-5440
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024

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 3

Control Number 29-AS-20231212123032

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: HOME SWEET HOME CARE	FACILITY NUMBER: 565801300
	VISIT DATE: 11/07/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Following is a summary of the investigation finding:

During the initial complaint visit on 12/19/2023, LPA observed three (3) staff at the facility. At approximately 2:40pm, LPA toured the facility with staff which included but not limited to five (5) resident rooms, two (2) staff room, kitchen/dining and common areas. Administrator was contacted and arrived shortly. Between 3pm - 4:45pm, LPA conducted interviews with three (3) out of the (5) residents and all three (3) staff. Resident files were reviewed at approximately 4:50pm.

Regarding allegation “Staff are not adhering to personal hygiene and food services sanitation practices” - The three staff interviewed denied the allegation and stated that any staff who prepare and handle food follow proper food service sanitation practices. Administrator stated that the staff practice food sanitation practices; wash hands, sanitize counters and high touch surface areas in the home several times daily. Residents interviewed confirmed staff maintain facility cleanliness including but not limited to the facility kitchen and also practice good hygiene and food service sanitation when in the kitchen preparing meals.

Based on the above information gathered, although the allegation may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the above allegation “Staff are not adhering to personal hygiene and food services sanitation practices” is deemed unsubstantiated at this time.

Regarding allegation “Staff are not maintaining a comfortable temperature for resident while in care” – During initial visit facility temperature observed set at 78 degrees Fahrenheit. Staff interviewed reported that the thermostat is set at a comfortable temperature for residents in care. According to staff and administrator resident windows are never left open during the night. Staff and administrator report that residents’ windows are only opened during the day to air out the rooms. It was further stated by staff that if resident express that they don’t want the window open they will not leave the window open. Resident interviews revealed that the facility temperature is comfortable and never cold in the facility.

Based on the above information gathered, although the allegation may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the above allegation “Staff are not maintaining a comfortable temperature for resident while in care” is deemed unsubstantiated at this time.

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Zabel Chochian	TELEPHONE: (818) 419-5440
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 29-AS-20231212123032

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: HOME SWEET HOME CARE	FACILITY NUMBER: 565801300
	VISIT DATE: 11/07/2024

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Regarding allegation “Staff are arguing in the presence of residents in care” – Staff interviewed denied allegation and reported to LPA that they never argue at the facility. Staff and administrator confirmed that staff may at times communicate in their language and it may sound loud. Residents interviewed reported that they have not seen staff argue or act inappropriately at the facility.

Based on the above information gathered, although the allegation may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the above allegation “Staff are arguing in the presence of residents in care” is deemed unsubstantiated at this time.

Regarding allegation “Staff do not ensure that resident is able to engage in their prescribed physical therapy exercises” – It was reported that due to positive COVID case residents are forced to stay in their room and are missing out on needed physical therapy. Staff and administrator reported that two residents tested positive for COVID during the Thanksgiving Holiday and therefore these residents were isolated and unable to obtain any outside agency services during that time. Administrator reported that physical therapy was postponed for one resident (resident #1) during the isolation period. Administrator stated that the physical therapy for residents are encouraged when needed and appropriate space for the services is provided. Residents interviewed did not express any issues with missing out on any appointments at the time of the COVID cases. Resident #1 confirmed testing positive during the thanksgiving holiday and therefore did not receive any services during that time.

Based on the above information gathered, although the allegation may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the above allegation “Staff do not ensure that residents engage in their prescribed physical therapy exercises” is deemed unsubstantiated at this time.

Exit interview conducted. Copy of report provided.

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Zabel Chochian	TELEPHONE: (818) 419-5440
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 3