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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565850112
Report Date: 11/29/2022
Date Signed: 11/29/2022 06:03:18 PM

Unsubstantiated


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
11/28/2022 and conducted by Evaluator Kasandra Lopez
COMPLAINT CONTROL NUMBER: 29-AS-20221128140855
FACILITY NAME:REGENCY PALMS OXNARDFACILITY NUMBER:
565850112
ADMINISTRATOR:KENNETH MAHLERFACILITY TYPE:
740
ADDRESS:1020 BISMARK LANETELEPHONE:
(805) 247-0227
CITY:OXNARDSTATE: CAZIP CODE:
93033
CAPACITY:127CENSUS: 56DATE:
11/29/2022
UNANNOUNCEDTIME BEGAN:
11:57 AM
MET WITH:Ken MahlerTIME COMPLETED:
04:55 PM
ALLEGATION(S):
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Facility staff did not safeguard resident's personal belongings.
Facility staff had inappropriate interaction with resident.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) KaSandra Lopez conducted an unannounced initial complaint inspection at the facility today regarding the above allegations. The LPA met with Administrator Ken Mahler at 12:01 PM and explained the reason for the visit.

During today's inspection, the LPA along with the Administrator conducted a physical plant inspection of the facility beginning at 12:12 PM. During the inspection, the LPA also conducted interviews with six residents, three caregivers, and the Administrator. The LPA also conducted record review beginning at 2:53 PM.

The allegation of 'Facility staff did not safeguard resident's personal belongings' alleges Resident #1 (R1) is missing approximately $200 from their apartment. Information received and the interview with R1 revealed the money went missing around November 8th, 2022. R1 reported they did not inform the Administrator that they had any missing items from their room. Report continued on LIC 9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Kasandra LopezTELEPHONE: (818) 421-5183
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 29-AS-20221128140855
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: REGENCY PALMS OXNARD
FACILITY NUMBER: 565850112
VISIT DATE: 11/29/2022
NARRATIVE
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Record review revealed R1 manages their own finances. Interviews with the five other residents revealed no reports of missing items from their apartments. Interview with staff and the Administrator revealed no reports of missing items from any residents, including Resident #1 (R1). The Administrator and Maintenance Director Mike Day also stated R1 has not requested any locked cabinets for safe keeping of personal belongings in their room since moving into the facility. Based on the information obtained, there is insufficient evidence to support the allegation of 'Facility staff did not safeguard resident's personal belongings.' Therefore, the allegation is deemed unsubstantiated at this time. The Administrator advised they will complete the necessary forms and reports for R1 in compliance with the facility's Theft and Loss policy now that they are aware of the allegation.

The allegation of 'Facility staff had inappropriate interaction with resident' alleges Staff #1 (S1) is disrespectful and has an attitude with Resident #1 (R1). Interviews with five resident revealed no concerns regarding the treatment they receive from any staff at the facility, including S1. Interviews with staff revealed no complaints from residents pertaining to S1. During the interview with S1 they denied being rude or disrespectful with R1. Based on the information obtained, there is insufficient evidence to support the allegation. Therefore, the allegation is deemed unsubstantiated at this time.

Exit interview and report reviewed with the Administrator. A copy of the report and appeal rights will be emailed.
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Kasandra LopezTELEPHONE: (818) 421-5183
LICENSING EVALUATOR SIGNATURE:

DATE: 11/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/29/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2