565802472-2-12-2024-29-AS-KLOZ-D3SPM2-20240328112538

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565802472
Report Date: 02/12/2024
Date Signed: 02/12/2024 12:54:42 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
02/05/2024 and conducted by Evaluator Esther Cortez

COMPLAINT CONTROL NUMBER: 29-AS-20240205083319

FACILITY NAME:	VENTURA GRAND CHATEAU		FACILITY NUMBER:	565802472
ADMINISTRATOR:	MICHAEL DIMAGUILA		FACILITY TYPE:	740
ADDRESS:	5430 TELEGRAPH ROAD		TELEPHONE:	(805) 642-2567
CITY:	VENTURA	STATE: CA	ZIP CODE:	93003
CAPACITY:	49	CENSUS: 37	DATE:	02/12/2024
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Sean Beharry		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff did not address an outbreak

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPA) Esther Cortez arrived unannounced at 10:00 a.m. to conduct an initial 10-day complaint visit. The LPA met with Administrator Sean Beharry and explained the reason for the visit.

During today's visit, the LPA obtained documents, conducted a file review, and conducted staff interviews from 10:00 a.m. - 12:30 p.m.

It was alleged that Staff did not address an outbreak. It was reported that residents and staff have visible rashes and residents are constantly itching. It was further reported that this has been going on for months and that the rash is contagious. Interviews conducted with staff revealed that there are residents and staff who are currently experiencing rashes and itchiness and it has been ongoing for months.

Report will continue on LIC9099-C.

Substantiated

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: 02/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024

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-20240205083319

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: VENTURA GRAND CHATEAU	FACILITY NUMBER: 565802472
	VISIT DATE: 02/12/2024

NARRATIVE

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Additionally, administrator Sean stated that two residents (R1, R2) had recently been taken to urgent care and diagnosed with suspected Scabies. However, Incident reports regarding the Infectious disease for R1 and R2 were not submitted to CCLD and Ventura County Public Health (VCPH) was not notified. Review of documents revealed that R1 had been diagnosed with presumed scabies and prescribed Permethrin on 02/07/2024. Furthermore, R2 had been prescribed Permethrin on 1/31/2024. Administrator stated they had not notified CCLD or Public Health due to other residents who were presenting with rashes and itchiness being diagnosed with contact Dermatitis and were waiting for a Dermatologist who was scheduled to visit the facility and test the residents and staff for scabies and confirm if they had scabies. During today’s visit Administrator Sean notified VCPH of the two residents with presumed scabies and possible scabies outbreak and obtained guidance on how to move forward. VCPH will be meeting with the facility this week to address the outbreak. Based on the information obtained during the course of the investigation, the allegation of “Staff did not address an outbreak.” is deemed Substantiated at this time.

Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 9099-D). Failure to correct the deficiencies may result in civil penalties.

Exit interview conducted. A copy of the appeal rights and report was issued.

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Esther Cortez	TELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20240205083319

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: VENTURA GRAND CHATEAU	FACILITY NUMBER: 565802472
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/12/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/13/2024 Section Cited CCR 87211(a)(2)	1 2 3 4 5 6 7	87211 Reporting Requirements (a)(2) Occurrences, such as epidemic outbreaks, ...or major accidents which threaten the welfare, safety or health of residents...shall be reported within 24 hours either by telephone or facsimile to the licensing agency This requirement is not met as evidenced by:	1 2 3 4 5 6 7	During todays visit the administrator contacted VCPH who will be visiting the facility this week and adressing the outbreak and has agreed to submit to Incident Reports to CCL in the timeline reflected in section 87211. Will submit Incident Reports for R1 and R2 by 2/13/2024.
	8 9 10 11 12 13 14	Based on interview and record review, the licensee did not comply with the section cited above, as R1 and R2 were diagnosed with suspected/presumed scabies, yet CCL and VCPH were not notified, which poses a potential health and personal rights risk to residents in care.	8 9 10 11 12 13 14
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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.

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Esther Cortez	TELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:	DATE: 02/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024

LIC9099 (FAS) - (06/04)

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