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Department of
SOCIAL SERVICES
Community Care Licensing
COMPLAINT INVESTIGATION REPORT
Facility Number:
565801810
Report Date:
04/22/2022
Date Signed:
04/22/2022 04:47:39 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., STE. 250
WOODLAND HILLS
,
CA
91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/16/2020
and conducted by Evaluator
Joann Rosales
PUBLIC
COMPLAINT CONTROL NUMBER:
31-AS-20200316154737
FACILITY NAME:
VENTURA TOWNEHOUSE
FACILITY NUMBER:
565801810
ADMINISTRATOR:
EVAN GRANUCCI
FACILITY TYPE:
740
ADDRESS:
4900 TELEGRAPH ROAD
TELEPHONE:
(805) 642-3263
CITY:
VENTURA
STATE:
CA
ZIP CODE:
93003
CAPACITY:
566
CENSUS:
222
DATE:
04/22/2022
UNANNOUNCED
TIME BEGAN:
04:10 PM
MET WITH:
Marissa Fontanilla
TIME COMPLETED:
04:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not follow the care plan
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) JoAnn Rosales conducted a subsequent unannounced complaint investigation visit to deliver final investigation findings. LPA met with staff Marissa Fontanilla who is authorized to review and sign reports Administrator Evan Granucci was on speakerphone as well.
Concerns were that staff were not following the care plan for resident #1 (R1) as staff did not put R1 in bed under the covers with a wedge pillow under R1 to prevent falls on 7/5/19. Interview with random staff on 4/22/22 starting at 1:10 pm revealed that staff would place R1 in the middle of the bed with their blankets on top of them elevating their feet with a pillow. Interviews with random staff conducted on 4/19/22 starting at 3:06 pm and 4/18/22 starting at 11:27 revealed that they did not recall R1 having a wedge pillow. A review of R1’s records on 4/18/22 starting at 10:00 am revealed that there was no physician’s order on file or notes in R1’s care plan indicating that staff place a wedge pillow under R1’s feet to prevent falls. Based on the
Continued on 9099D
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME:
Naira Margaryan
TELEPHONE:
(818) 596-4368
LICENSING EVALUATOR NAME:
Joann Rosales
TELEPHONE:
(626) 419-4072
LICENSING EVALUATOR SIGNATURE:
DATE:
04/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
04/22/2022
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
31-AS-20200316154737
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., STE. 250
WOODLAND HILLS
,
CA
91364
FACILITY NAME:
VENTURA TOWNEHOUSE
FACILITY NUMBER:
565801810
VISIT DATE:
04/22/2022
NARRATIVE
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5
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8
9
10
11
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14
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20
21
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27
28
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31
32
information obtained during the course of the investigation the allegation is deemed unsubstantiated at this time.
Exit interview was conducted, today's report was reviewed and emailed to the Administrator
SUPERVISOR'S NAME:
Naira Margaryan
TELEPHONE:
(818) 596-4368
LICENSING EVALUATOR NAME:
Joann Rosales
TELEPHONE:
(626) 419-4072
LICENSING EVALUATOR SIGNATURE:
DATE:
04/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
04/22/2022
LIC9099
(FAS) - (06/04)
Page:
2
of
2