565850111-12-2-2021-29-AS-KHEN-CAVLRZ-20220121075959

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565850111
Report Date: 12/01/2021
Date Signed: 12/02/2021 08:40:46 AM

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
10/25/2021 and conducted by Evaluator Angel Ascencio

COMPLAINT CONTROL NUMBER: 29-AS-20211025144923

FACILITY NAME:	LEXINGTON ASSISTED LIVING		FACILITY NUMBER:	565850111
ADMINISTRATOR:	SANJUANA ENRIQUEZ		FACILITY TYPE:	740
ADDRESS:	5440 RALSTON ST		TELEPHONE:	(805) 644-6710
CITY:	VENTURA	STATE: CA	ZIP CODE:	93003
CAPACITY:	125	CENSUS: 70	DATE:	12/01/2021
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Matteo DiGrigoli		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Resident in care was inappropriately touched by another resident
Staff did not prevent resident's from engaging in verbal altercations

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angel Ascencio conducted an unannounced subsequent complaint visit to the above facility. The purpose of the visit is to conclude an investigation initiated by LPA on 10/27/2021. Upon arrival, LPA met with Matteo DiGrigoli, Operations Manager at 11:15 a.m. Entrance interview conducted and the reason for the visit was explained.

On 10/25/2021, the Department received a complaint alleging that resident in care was innappropriately touched by another resident. During resident interviews on 10/27/2021,11/23/2021 and 12/1/2021, it was revealed that residents have not been touched innapropiately by other residents. Furthermore, some residents developed intimate relationship with others and have shown public affection within the facility. Continued resident interviews revealed that they see the couples kiss and show affection during dinning hours, deeming the behavior as inappropriate. Staff interviews on 10/27/2021,11/23/2021 and 12/1/2021 revealed that they have not heard or seen any innappropriate behavior coming a staff or resident towards
CONTINUED ON LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Angel Ascencio	TELEPHONE: 747-230-3888
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021

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-20211025144923

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: LEXINGTON ASSISTED LIVING	FACILITY NUMBER: 565850111
	VISIT DATE: 12/01/2021

NARRATIVE

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another resident. Although the allegation may have happened, there is not a preponderance of evidence to prove the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time.

The complaint also alleged that staff did not prevent resident's from engaging in verbal altercations. Interview on 10/27/2021 with Matt revealed that there was a verbal altercation between the two (2) residents, but it did not get physical. Matt was told that they were yelling at each other and that staff came in and removed them both. Staff #1 (S1) interview on 11/23/2021 revealed that about 2 months ago, Resident #1 (R1) and Resident #2 (R2) were in an activity when R2 started to yell and call R1 names because are R1 was people watching. R1 and R2 got confrontational that S1 had to step in between the 2, called for assistance from other staff members. Once the staff members arrived, both R1 and R2 were removed from the activity room. Interview with S2 and S3 revealed that there was another verbal altercation between R1 and R2 in the dinning room. R1 would frequently buy snacks at a liqueur store. R2 would eat the snacks and would tell R1 to pick up their trash. R1 became upset and stopped purchasing snacks. R2 confronted R1 in the dinning room and began yelling and screaming. S2 and S3 stepped in between R1 and R2, called other staff for escort assistance to remove both residents from the dinning room. Additional staff interviews on 11/23/2021 revealed that since the verbal altercations, R1 and R2 have not been confrontational and have attending activities throughout the community with continued reminders of code of conduct. Although the allegation may have happened, there is not a preponderance of evidence to prove the alleged violation occurred. Therefore, the allegation is unsubstantiated at this time.

Although both allegations have been determined to be unsubstantiated, a conversation was held with the Operations Manager during the exit interview of today’s visit. LPA stressed the importance of knowing clients’ personal rights and having staff that are property trained to handle any situation. LPA advised to conduct additional training on behavior interventions.

Exit interview conducted. Copy of the report provided via email.

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Angel Ascencio	TELEPHONE: 747-230-3888
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2021

LIC9099 (FAS) - (06/04)

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