565850112-3-14-2023-29-AS-DPEA-CYMVZU-20231218155313

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565850112
Report Date: 03/14/2023
Date Signed: 03/14/2023 02:07:20 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
03/10/2023 and conducted by Evaluator Martha Arroyo

COMPLAINT CONTROL NUMBER: 29-AS-20230310122826

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: 58	DATE:	03/14/2023
		UNANNOUNCED	TIME BEGAN:	11:20 AM
MET WITH:	Ken Mahler		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Residents are not being provided with activities

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Martha Arroyo and Esther Cortez conducted an unannounced initial complaint visit for the above allegations. Upon arrival, LPAs met with Executive Director (ED), Ken Mahler and the reason for visit was explained. Entrance interview conducted.

During today's visit, the LPAs toured the facility at 11:48am, conducted interviews with the ED, one staff, and one resident between 11:30am and 1:12pm. At 12:20 pm, the LPAs conducted a record review and obtained a copy of the resident roster, staff roster, staff schedule, Activity Calendar, and obtained copies of pertinent documents relevant to the investigation.

Report Continued on LIC 9099C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Martha Arroyo	TELEPHONE: (818) 421-6459
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2023

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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Control Number 29-AS-20230310122826

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: 03/14/2023

NARRATIVE

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Report Continued from LIC 9099...

While conducting the facility tour, LPAs observed an activities board posted by the main entrance as well as a sign-up sheet for activities offered at a future date and time. LPAs were also provided a copy of the activities calendar for the day that is available by the lobby. At 12:46pm, LPAs observed staff and residents inside the activities room decorating cupcakes. Interviews conducted with staff revealed monthly activities calendar are both posted and handed to each resident. Additionally, residents are able to participate in all activities and staff will assist the residents to the activities if needed. Interview with resident revealed staff has previously assisted them to go outside and participate in activities; however, they prefer to stay in their rooms. Based on interviews, observation, and documents obtained and reviewed, the Department does not have sufficient evidence to support the allegation of “residents are not being provided with activities”. Therefore, the allegation is deemed Unsubstantiated at this time.

Exit interview. No citations issued during this visit. Report was reviewed and issued to the Executive Director.

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Martha Arroyo	TELEPHONE: (818) 421-6459
LICENSING EVALUATOR SIGNATURE:	DATE: 03/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2023

LIC9099 (FAS) - (06/04)

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