565802461-12-21-2022-29-AS-JAPL-CQ5VYA-20230321165049

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565802461
Report Date: 12/21/2022
Date Signed: 12/21/2022 04:57:23 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. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/20/2022 and conducted by Evaluator Teresa Camara

COMPLAINT CONTROL NUMBER: 29-AS-20221220164213

FACILITY NAME:	SUNRISE AT WOOD RANCH		FACILITY NUMBER:	565802461
ADMINISTRATOR:	EDITH KENNEDY		FACILITY TYPE:	740
ADDRESS:	190 TIERRA REJADA RD		TELEPHONE:	(805) 584-8881
CITY:	SIMI VALLEY	STATE: CA	ZIP CODE:	93065
CAPACITY:	100	CENSUS: 65	DATE:	12/21/2022
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Edith Kennedy		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Facility is not following COVID protocols

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Teresa Camara conducted an unannounced initial complaint visit to this facility. The LPA met with Executive Director Edith Kennedy (ED) and explained the reason for the visit.

During today’s visit, the LPA interviewed the ED at 8:57 a.m. LPA reviewed emails and documents sent to and received from Ventura County Public Health (VCPH), Community Care Licensing (CCL), and resident's families at 9:20 a.m. Based on the interview and emails, it appears the ED followed guidelines set forth by VCPH and CCL during the community's recent COVID-19 outbreak. During the height of the outbreak the dining room and activities were shutdown and families were asked to minimize traffic at the facilty. The faciltiy was never instructed to ban visitors or restrict COVID negative residents from leaving the facility. The facility has been testing everyone (residents and staff) twice per week and has had two rounds of negative tests. The dining room and activities have been reopened while encouraging physical distancing and mask wearing.
Based on LPA's interview and record review, the above noted allegation is deemed Unsubstantiated at this time. A copy of the report was emailed to ED.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Teresa Camara	TELEPHONE: 818-326-4019
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2022

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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