565850112-9-14-2023-29-AS-DPEA-D4T34E-20240429175457

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565850112
Report Date: 09/14/2023
Date Signed: 09/14/2023 10:41:05 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
09/08/2023 and conducted by Evaluator Teresa Camara

COMPLAINT CONTROL NUMBER: 29-AS-20230908093134

FACILITY NAME:	REGENCY PALMS OXNARD		FACILITY NUMBER:	565850112
ADMINISTRATOR:	KENNETH MAHLER		FACILITY TYPE:	740
ADDRESS:	1020 BISMARK LANE		TELEPHONE:	(805) 247-0227
CITY:	OXNARD	STATE: CA	ZIP CODE:	93033
CAPACITY:	127	CENSUS: 72	DATE:	09/14/2023
		UNANNOUNCED	TIME BEGAN:	09:07 AM
MET WITH:	Kenneth Mahler		TIME COMPLETED:	10:20 AM

ALLEGATION(S):

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Licensee is refusing to give refund without a signed release

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Teresa Camara conducted an intitial complaint investigation visit. LPA met with executive director (ED) Kenneth Mahler and explained the reason for the visit.

At 9:10 a.m. LPA conducted a joint interview with the ED and staff 1 (S1). Based on the complaint allegations the ED knew which resident this complaint was regarding. Resident 1 (R1) was at the facility for respite and was deemed mostly independent. The facility staff assisted R1 with medications and was available to R1 if any assistance was needed. At 9:20 a.m. S1 and ED gathered documents requested by LPA. R1's admission agreement showed the non-refundable fees paid by R1 totaled $1,900 ($500 community/assessment fee and $1,400 rent for seven days). R1 lived at the facility two days, had two falls and then transferred to a skilled nursing facility. The ED provided evidence to LPA that the total amount of $1,900 was electronically refunded to R1 on 9/14/2023. Based on this information, the above noted allegation is deemed Unsubstantiated at this time. Copy of report issued to ED.

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: 09/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

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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