565802467-12-18-2024-29-AS-KBUY-DG6ULC-20250428154030

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565802467
Report Date: 12/17/2024
Date Signed: 12/18/2024 08:13:29 AM

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
12/10/2024 and conducted by Evaluator Teresa Camara

COMPLAINT CONTROL NUMBER: 29-AS-20241210133314

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:	DATE:	12/17/2024
		UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Brandy McCauley		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff did not safeguard resident's funds

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Teresa Camara conducted a complaint investigation visit regarding the above noted allegation. LPA met with administrator Brandy McCauley and explained the reason for the visit.

At 12:53 p.m. LPA interviewed administrator, at 1:07 p.m. LPA interviewed the resident care director and at 1:57 p.m. LPA interviewed resident 1 (R1) by phone while at the facility.

R1 confirmed the alleged perpetrator (P1) of the financial abuse was not an employee of this facility. P1 was someone R1 met through a nurse from an outside agency. P1 presented themself as an unemployed registered nurse who offered to help R1 with shopping and other personal assistance. R1 stated they

(continued on LIC9099-C, page 2)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 593-4347
LICENSING EVALUATOR NAME: Teresa Camara	TELEPHONE: 818-326-4019
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

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-20241210133314

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: 12/17/2024

NARRATIVE

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(continued from LIC9099, page 1)

did not talk about how much they would pay for P1's assistance. R1 had given their debit card and PIN to P1 so P1 could buy items for R1. Unfortunately, R1 discovered P1 made over $1,400 in unauthorized purchases. Facility staff assisted R1 in contacting the police and adult protective services.

In addition, R1 noticed their social security check was no longer going into their bank account and they were concerned P1 had gotten their social security information. Facility staff assisted R1 in getting to the social security office and they discovered R1's checks were stopped due to social security having the wrong address for R1. That was corrected on 12/12/2024 and R1 should be receiving their social security checks again.

Based on information obtained in interviews, the above noted allegation that staff did not safeguard resident's funds is deemed Unsubstantiated at this time.

No deficiencies were observed. Exit interview conducted and report issued.

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 593-4347
LICENSING EVALUATOR NAME: Teresa Camara	TELEPHONE: 818-326-4019
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

LIC9099 (FAS) - (06/04)

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