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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565802425
Report Date: 01/29/2025
Date Signed: 01/29/2025 04:37:32 PM

Substantiated


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
11/05/2024 and conducted by Evaluator Teresa Camara
PUBLIC
COMPLAINT CONTROL NUMBER: 29-AS-20241105145942
FACILITY NAME:VISTAS AT OXNARD SENIOR LIVING,THEFACILITY NUMBER:
565802425
ADMINISTRATOR:RICK OLDSFACILITY TYPE:
740
ADDRESS:2211 E GONZALES RDTELEPHONE:
(805) 983-6808
CITY:OXNARDSTATE: CAZIP CODE:
93036
CAPACITY:100CENSUS: 32DATE:
01/29/2025
UNANNOUNCEDTIME BEGAN:
11:42 AM
MET WITH:Jovany GuerraTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff does not treat residents with dignity
Residents missed medications
Medications were accessible to residents in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Teresa Camara conducted a subsequent complaint investigation visit regarding the above noted allegations. LPA met with Executive Director (ED) Jovany Guerra and explained the reason for the vsit.

At 11:45 a.m. LPA interviewed ED. At 12:40 p.m. LPA obtained pertient documents. LPA interviewed three other staff at 1:12 p.m., 1:56 p.m. and 3:00 p.m. LPA interviewed a resident at 2:25 p.m.

Regarding the allegation staff does not treat residents with dignity: It was reported Staff 1 (S1) was speaking to residents in a disrespectful manner. S1 received a disciplinary action write up dated 10/19/2024 in which it

(continued on LIC9099C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
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-20241105145942
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: VISTAS AT OXNARD SENIOR LIVING,THE
FACILITY NUMBER: 565802425
VISIT DATE: 01/29/2025
NARRATIVE
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(continued from LIC9099)

it indicated S1 needed to "maintain a professional demeanor with residents and refrain from discussing unrelated care matters with them." Staff 2 (S2) and Staff 3 (S3) had witnessed S1 speak to residents in a rude manner, however S1 has improved in how they interact with residents. Resident 1 (R1) stated S1 had spoke to them rudely in the past, however S1 is very nice to them now. While S1's demeanor with residents has improved, based on interviews and record review, the allegation S1 does not treat residents with dignity is Substantiated for the time frame this complaint was reported.

Regarding the allegation residents missed medications: It was reported S1 was noting on the medication administration record (MAR) the bedtime medications for memory care residents had been given, however a NOC shift medication technician witnessed the medications remained in the top drawer and were not given. Later, the medications were gone. Bedtime medications are usually given at approximately 8:00 p.m. Staff assumed the medications were destroyed since it was too late to administer the medications but there was nothing noted on the MAR about residents missing their medications. Staff stated this happened on more than one occasion and it was reported to the previous ED. Staff was not sure if anything was addressed with S1 by the prior ED. In addition, a resident complained about being given their medications late by S1 and S1 received a disciplinary write-up with that noted. While S1's performance with medications has reportedly improved, based on interviews and record review, the allegation residents missed medications is Substantiated for the time frame this complaint was reported.

Regarding the allegation medications were accessible to residents in care: It was reported while S1 passed out medications cups to the assisted living residents seated in the dining room for dinner, S1 would leave the medications cups on the table rather than wait for residents to take their medications. This was confirmed during interviews with other staff. In addition, this led to one resident taking another resident's medications. Staff stated they informed the previous ED of this medication error. While S1's performance with medications has reportedly improved, based on interviews, the allegation medications were accessible to residents in care is Substantiated for the time frame this complaint was reported.

The following deficiency was observed (See LIC 9099-D) and cited from the California Code of Regulations, Title 22. Failure to correct the deficiency may result in civil penalties.

Exit interview conducted. A copy of the report and appeal rights were provided.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 29-AS-20241105145942
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: VISTAS AT OXNARD SENIOR LIVING,THE
FACILITY NUMBER: 565802425
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/29/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/29/2025
Section Cited
CCR
87465(h)(2)
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87465 Incidental Medical and Dental Care (h) The following requirements shall apply to medications which are centrally stored:
(2) Centrally stored medicines shall be kept in a safe and locked place that is not accessible to persons other than employees... This requirement was not met as evidenced by:
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S1 already received disciplinary action, counseling and training. In addition, licensee has scheduled medication training with all medications technicians again on 1/30/2025. POC cleared.
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Based on interviews, the licensee did not comply with the above cited section, as witnesses stated S1 left medication on dining room tables unattended by staff and left meds in a drawer, which posed an immediate health and safety risk to persons in care.
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Type B
01/29/2025
Section Cited
CCR
87468.1(a)(1)
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87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (1) To be accorded dignity in their personal relationships with staff, residents, and other persons. This requirement was not met as evidenced by:
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S1 already received disciplinary action, counseling and training. In addition, it has been witnessed S1's demeanor with residents has greatly improved. POC cleared.
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Based on interviews, the licensee did not comply with the above cited section, as witnesses stated S1 spoke in a rude manner to residents, which posed a potential health and safety risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2025
LIC9099 (FAS) - (06/04)
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