565801979-3-15-2024-29-AS-DPEA-D5T3W4-20240531183603

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565801979
Report Date: 03/15/2024
Date Signed: 03/15/2024 04:24:59 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
05/04/2022 and conducted by Evaluator Esther Cortez

COMPLAINT CONTROL NUMBER: 29-AS-20220504134133

FACILITY NAME:	WELLNESS CARE SENIOR LIVING		FACILITY NUMBER:	565801979
ADMINISTRATOR:	ALEIDA ALONSO		FACILITY TYPE:	740
ADDRESS:	158 ROCKAWAY ROAD		TELEPHONE:	(805) 649-5143
CITY:	OAK VIEW	STATE: CA	ZIP CODE:	93022
CAPACITY:	56	CENSUS: 27	DATE:	03/15/2024
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Maria Hernandez		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Facility does not have adequate food supplies

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Esther Cortez conducted a subsequent complaint visit for the above allegations. Upon arrival, LPA met with Administrator Maria Hernandez and was explained the reason for the visit. Entrance interview conducted.

During today's inspection, between 10:45 a.m. and 4:00 p.m., the LPA interviewed the Administrator, staff, residents, two (2) Individuals, conducted a file review, and obtained copies of resident records and other pertinent documents relevant to the investigation.

Report will continue on LIC9099-C.

Unsubstantiated

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: 03/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2024

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-20220504134133

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: WELLNESS CARE SENIOR LIVING	FACILITY NUMBER: 565801979
	VISIT DATE: 03/15/2024

NARRATIVE

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Regarding the allegation: Facility does not have adequate food supplies; it is the reporting party’s concern that the facility has low food supplies and no emergency food items. It was further reported that the facility has no food at all because the owner wants to save money and the residents are only provided water as a meal. To investigate the complaint the LPA conducted a tour of the kitchen, pantry and break room, and conducted staff and resident interviews. In addition, on 05/12/2022 LPA Rosales conducted staff and resident interviews. The LPA observed the sufficient two (2) days perishables and seven (7) days non-perishable foods which included food from all groups such as meats, dairy, eggs, breads, and fresh fruits that included apples, and bananas. The LPA observed emergency food and water in a pantry located in the staff break room. Interviews conducted with the Administrator revealed that food is delivered to the facility weekly on Thursdays and Fridays by two large food supply companies. Staff and resident interviews conducted revealed that residents have always been provided with food and drinks.
Based on LPA observations, and interviews conducted, the Department does not have sufficient evidence to support the allegation of “Facility does not have adequate food supplies;”. Therefore, this allegation is deemed Unsubstantiated at this time.

Exit interview conducted. No citations issued. 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: 03/15/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2024

LIC9099 (FAS) - (06/04)

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