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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565802454
Report Date: 03/16/2022
Date Signed: 03/16/2022 07:00:48 PM



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
06/29/2020 and conducted by Evaluator Zabel Chochian
COMPLAINT CONTROL NUMBER: 29-AS-20200629131806
FACILITY NAME:FOOTHILLS AT SIMI VALLEY, THEFACILITY NUMBER:
565802454
ADMINISTRATOR:BOGOYEVAC, LEATRICEFACILITY TYPE:
740
ADDRESS:5300 E LOS ANGELES AVENUETELEPHONE:
(805) 583-3500
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93063
CAPACITY:175CENSUS: 85DATE:
03/16/2022
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Leatrice BogoyevacTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Facility staff not allowing resident to communicate with family.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Zabel Chochian conducted a subsequent complaint visit to deliver final finding for the above allegation. The initial visit was conducted on 06/30/2020 by LPA Joann Rosales. During today’s visit, LPA met with Administrator Leatrice Bogoyevac and explained the reason for the visit.

On 06/29/2020, the Department received a complaint in which it was alleged that facility staff are not allowing residents to communicate with family. Following is a summary of the investigation:
Interview was conducted with Administrator on 6/30/2020 at 11:05AM; during another complaint visit on 11/6/2020 a physical plant tour was conducted again and staff and random resident interviews was conducted between 12:30PM and 3:45PM. LPA also conducted random resident interviews during todays visit (3/16/2022). Interviews revealed that residents made and received private phone calls during the pandemic to present. Administrator interview revealed that during the pandemic it was a big challenge and visiting was allowed with limitations. There were no restrictions put on residents communicating with family.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 596-4337
LICENSING EVALUATOR NAME: Zabel ChochianTELEPHONE: (818) 419-5440
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022
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 29-AS-20200629131806
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: FOOTHILLS AT SIMI VALLEY, THE
FACILITY NUMBER: 565802454
VISIT DATE: 03/16/2022
NARRATIVE
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 Ten (10) out of ten (10) random residents interviewed during the course of investigation expressed that they were/are able to make and receive calls from family and friends. Staff interviews revealed that residents did not have any communication restrictions and were and are able to do so freely.

Based on interviews conducted, there is insufficient evidence to support the allegation.
Therefore the allegation "Facility staff not allowing resident to communicate with family" is deemed UNSUBSTANTIATED at this time.

Exit interview conducted. A copy of the report will be provided by email to Administrator..
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 596-4337
LICENSING EVALUATOR NAME: Zabel ChochianTELEPHONE: (818) 419-5440
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2