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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 565802472
Report Date: 07/11/2024
Date Signed: 07/11/2024 04:44:16 PM


Document Has Been Signed on 07/11/2024 04:44 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT
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 CHATEAUFACILITY NUMBER:
565802472
ADMINISTRATOR:MICHAEL DIMAGUILAFACILITY TYPE:
740
ADDRESS:5430 TELEGRAPH ROADTELEPHONE:
(805) 642-2567
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY:49CENSUS: 37DATE:
07/11/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:32 AM
MET WITH:Sean BeharryTIME COMPLETED:
04:00 PM
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Licensing Program Analyst (LPA) Teresa Camara conducted a Case Management - Incident visit regarding a self reported incident which took place on or about 7/10/2024. LPA met with administrator Sean Beharry and explained the reason for the visit.

Starting at 9:38 a.m. LPA conducted interviews with administrator and two staff. LPA conducted an interview with Resident 1 (R1) at 10:42 a.m. LPA reviewed records during the interview with administrator.

On 7/10/2024, at approximately 7:30 a.m. Staff 1 (S1) noticed R1 was not in their room. S1 asked Staff 2 (S2) if they knew where R1 was and S2 did not know R1 was missing. Staff conducted a search of the facility and grounds. S1 noticed a plastic chair was placed near the fence and had a shoe print on it. The police were notified of the missing resident. Staff drove around the neighborhood searching for R1. Administrator stated R1 was last seen by Staff 3 (S3) at approximately 9:30 p.m. on 7/9/2024. Staff located R1 at a nearby shopping center on a bus bench between 7:00-8:00 p.m. on 7/10/2024. A review of R1's records showed R1 was not allowed to leave the facility unassisted by staff. R1 had never displayed any exit seeking behavior.

When asked by LPA why they left, R1 stated they were bored and wanted to go get a burger at McDonald's. R1 confirmed they climbed the fence to exit the facility. R1 stated they miss their family and would like to live with their family or closer to their family. R1 also stated they do not want to take medications prescribed by their physician and they are not interested in looking at alternatives to their current medication because they do not feel they need the medications.

Administrator stated he is reviewing this with his manager and R1's representative to determine if this is appropriate placement for R1. In the meantime, staff are to keep a closer eye on the courtyard, the chairs that R1 used to climb the fence, and watch for R1 exit seeking.

No deficiencies observed at this time. Exit interview conducted and report issued.
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 593-4347
LICENSING EVALUATOR NAME: Teresa CamaraTELEPHONE: 818-326-4019
LICENSING EVALUATOR SIGNATURE:
DATE: 07/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/11/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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