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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565801637
Report Date: 10/23/2024
Date Signed: 10/23/2024 12:17:33 PM

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
10/16/2024 and conducted by Evaluator Teresa Camara
PUBLIC
COMPLAINT CONTROL NUMBER: 29-AS-20241016084837
FACILITY NAME:VETERANS HOME OF CALIFORNIA-VENTURAFACILITY NUMBER:
565801637
ADMINISTRATOR:CYNTHIA GAMBILLFACILITY TYPE:
740
ADDRESS:10900 TELEPHONE ROADTELEPHONE:
(805) 659-7501
CITY:VENTURASTATE: CAZIP CODE:
93004
CAPACITY:60CENSUS: 55DATE:
10/23/2024
UNANNOUNCEDTIME BEGAN:
10:04 AM
MET WITH:Cynthia GambillTIME COMPLETED:
12:35 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff is verbally abusing residents
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Teresa Camara conducted a complaint investigation visit regarding the above noted allegation. LPA met with administrator Cindy Gambill and explained the reason for the visit.

LPA interviewed ten (10) residents starting at 10:20 a.m. LPA interviewed dining room staff at 11:37 a.m. and the food service manager at 11:39 a.m. Based on interviews, one resident stated that Staff 1 (S1) seemed to not be catching on to the job as food server and needed extra training. The resident was not aware of S1 yelling at residents. None of the other residents observed or experienced any staff yelling or otherwise being rude to residents, nor had the dining room staff or manager who had been interviewed.

Based on interviews, the above noted allegation is deemed Unsubstantiated at this time.

Exit interview conducted and report issued.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 593-4347
LICENSING EVALUATOR NAME: Teresa CamaraTELEPHONE: 818-326-4019
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
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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