565802467-10-3-2023-29-AS-KLOZ-CYNP82-20231219100442

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565802467
Report Date: 10/03/2023
Date Signed: 10/03/2023 03:44:12 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
05/14/2021 and conducted by Evaluator Esther Cortez

COMPLAINT CONTROL NUMBER: 29-AS-20210514112111

FACILITY NAME:	PALMS AT BONAVENTURE ASSISTED LIVING, THE		FACILITY NUMBER:	565802467
ADMINISTRATOR:	MCCAULEY, BRANDY		FACILITY TYPE:	740
ADDRESS:	111 N WELLS ROAD		TELEPHONE:	(805) 647-0616
CITY:	VENTURA	STATE: CA	ZIP CODE:	93004
CAPACITY:	121	CENSUS: 92	DATE:	10/03/2023
		UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Brandy Mccauley		TIME COMPLETED:	03:50 PM

ALLEGATION(S):

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Staff handle residents in a rough manner
Staff does not assist with incontinence care
Insufficient staffing

INVESTIGATION FINDINGS:

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At 8:40 a.m. Licensing Program Analyst (LPA) Esther Cortez conducted an unannounced subsequent complaint visit to the above facility to continue investigation of the above allegations. LPA met with Administrator Brandy McCauley and explained the purpose of the visit.

LPA Rosales conducted the initial 10-day complaint visit on 05/17/2021 at 11:25 AM – 6:00 PM, the LPA reviewed resident records, obtained copies of pertinent documents and interviewed random residents. LPA Smith conducted a subsequent complaint visit on 06/13/2023 at 9:45 AM – 2:30 PM, interviewed nine (9) staff, conducted a medication audit, and interviewed four (4) residents. Today, LPA Cortez toured the facility with administrator Brandy McCauley at 10:00 am, reviewed all staff and resident interviews conducted by LPA Rosales and Smith, and interviewed two (2) staff and two (2) residents between 10:20 a.m. and 11:30 a.m.
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: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

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-20210514112111

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: PALMS AT BONAVENTURE ASSISTED LIVING, THE	FACILITY NUMBER: 565802467
	VISIT DATE: 10/03/2023

NARRATIVE

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Staff handle residents in a rough manner.
On the allegation that Staff handle residents in a rough manner, it is the concern of the reporting party that staff handle residents in a rough manner by pulling residents by their pants when transferring them, giving residents “wedges”. It was further alleged that the RP observed staff pushed a resident (R1) toward a railing when handling R1. During the initial and both subsequent complaint visits, the LPAs conducted interviews with various residents. Residents interviewed during the investigation revealed that staff treat them fine, and that “staff are very gentle and not rough”. None of the residents interviewed during the investigation voiced any concerns with staff handling them in a rough manner, with nine (9) out of eleven (11) residents stating that staff treated them fine, very well, staff are wonderful, or that they have never been handled inappropriately. In addition, R1 was interviewed during the initial complaint visit and revealed that no staff has pushed them, and that staff has never hurt or been rough with them. LPA Smith and Cortez interviewed staff during the subsequent complaint visits. Staff interviews revealed that seven (7) out of twelve (12) staff interviewed have not heard any complaints or concerns about staff handling residents in a rough manner. One out of twelve staff interviewed revealed that they had heard of staff being rough with a resident, however they did not witness it and only heard it from a peer. When asked if staff grabs on to residents clothing to transfer them staff gave mix responses, with three (3) staff stating they do not grab on the residents clothing and two (2) staff stating they do however, to guide the resident and not hurting them. Lastly staff interviews revealed that they have access to the residents’ care plans. If needed they will use a two-person assist, gait belt, hoyer lift or a sara lift machine to assist residents to transfer them. Based on the information gathered on the above allegations, although the allegations may have happened or is valid, there was insufficient evidence to confirm that Staff handle residents in a rough manner. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Report will continue on LIC9099-C.

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Esther Cortez	TELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 29-AS-20210514112111

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: PALMS AT BONAVENTURE ASSISTED LIVING, THE	FACILITY NUMBER: 565802467
	VISIT DATE: 10/03/2023

NARRATIVE

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Insufficient Staffing and Staff does not assist with incontinence care.
On the allegations that there is insufficient staffing, and that Staff does not assist with incontinence care, it is the concern of the reporting party that the facility is understaffed and that oftentimes, there are only 2 caregivers assigned to provide care for 60 residents. It was further alleged due to insufficient staffing, residents who are bedridden and residents that have dementia are left in soiled diapers for prolonged periods of time. During the initial and both subsequent complaint visits, the LPAs conducted interviews with various residents. Resident interviewed during the investigation revealed that “usually when they call staff will show up”, “that they think that they have enough staff,” and that “staff are taking care of their needs”. Resident Interviews also revealed that staff regularly check them and change their diapers, and even though there has been one time where a resident has been left soiled, it is rare. LPA Smith and Cortez interviewed staff during the subsequent complaint visits. Staff interviews revealed that residents are changed approximately every two hours or as needed. It may vary depending on the residents needs, if residents are “heavy wetters” or know they are in bed staff will check on them frequently. Staff interviews also revealed that AM staff often find residents with soiled diapers during shift change, however they are changed upon observation. Staff interviews also revealed that they are currently fully staff and will have approximately three to four caregivers per shift and a Med-Technician. It was further revealed that there are occasions where staff will call out, however the supervisor will have additional staff they can call to cover. Current weeks schedule was provided to LPA Cortez during today’s visit where it noted six (6) caregivers in assisted living (AL) and four caregivers in memory care (MC) for the 6 a.m. -2 p.m. morning shift; four (4) caregivers in AL, three caregivers in MC for the 2:00 p.m.-10:00 p.m. evening shift; and three (3) caregivers in AL, and two (2) caregivers in MC for the 10:00 p.m.-6:00 a.m. night shift. The LPA also observed six (6) on call caregivers on the facility’s schedule. Lastly, staff interviews revealed that the facility has had previous years where they were understaffed, however currently there is sufficient staffing. Based on the information gathered on the above allegations, although the allegations may have happened or is valid, there was insufficient evidence to confirm that there is Insufficient Staffing, and that Staff does not assist with incontinence care. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Exit interview conducted and a copy of the report was provided to the administrator.

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Esther Cortez	TELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

LIC9099 (FAS) - (06/04)

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