565850141-11-17-2022-29-AS-KBUY-CLNT6N-20221130132725

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565850141
Report Date: 11/17/2022
Date Signed: 11/17/2022 01:35:12 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
03/28/2022 and conducted by Evaluator Joann Rosales

PUBLIC

COMPLAINT CONTROL NUMBER: 29-AS-20220328145922

FACILITY NAME:	AEGIS LIVING VENTURA		FACILITY NUMBER:	565850141
ADMINISTRATOR:	LANCE SHENK		FACILITY TYPE:	740
ADDRESS:	4964 TELEGRAPH ROAD		TELEPHONE:	(805) 650-1114
CITY:	VENTURA	STATE: CA	ZIP CODE:	93003
CAPACITY:	100	CENSUS: 83	DATE:	11/17/2022
		UNANNOUNCED	TIME BEGAN:	01:04 PM
MET WITH:	Lance Shenk		TIME COMPLETED:	01:34 PM

ALLEGATION(S):

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Facility failed to respond to residents responsible person's correspondence

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) JoAnn Rosales conducted a subsequent complaint visit to deliver findings for the above allegation. LPA met with Executive Director Lance Shenk.

Concerns were that the facility failed to respond to residents responsible persons correspondence. On 3/29/22 starting at 1:03 pm interviews were conducted with facility staff, on 10/13/22 starting at 3:45 pm and on 11/9/22 starting at 3:57 pm interviews were conducted with residents responsible persons. Based on our investigation there is insufficient evidence to support the allegation that the facility failed to respond to residents responsible persons correspondence therefore, the allegation is deemed unsubstantiated at this time. There was a conversation held during today’s visit with Executive Director Lance Shenk regarding the allegation. Executive Director stated that they understood.

Exit interview conducted. Today's report and appeals rights were reviewed and emailed to the Executive Director.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kristin Heffernan	TELEPHONE: (818) 596-4493
LICENSING EVALUATOR NAME: Joann Rosales	TELEPHONE: (626) 419-4072
LICENSING EVALUATOR SIGNATURE:	DATE: 11/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2022

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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