565850243-1-16-2024-29-AS-DPEA-D2W8GC-20240228213006

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565850243
Report Date: 01/16/2024
Date Signed: 01/16/2024 01:29:08 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
01/08/2024 and conducted by Evaluator Martha Arroyo

COMPLAINT CONTROL NUMBER: 29-AS-20240108164943

FACILITY NAME:	LAUREL HEIGHTS		FACILITY NUMBER:	565850243
ADMINISTRATOR:	JOHNNY ORTIZ		FACILITY TYPE:	740
ADDRESS:	13960 PEACH HILL DRIVE		TELEPHONE:	(805) 292-0700
CITY:	MOORPARK	STATE: CA	ZIP CODE:	93021
CAPACITY:	112	CENSUS: 66	DATE:	01/16/2024
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Johnny Ortiz		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Administrator is not on the premises for a sufficient number of hours.
A qualified staff is not designated to operate the facility during administrator's absence.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Martha Arroyo conducted an initial 10-day complaint visit for the above allegations. Upon arrival, the LPA was greeted by the front desk receptionist. The LPA met with Executive Director (ED), Johnny Ortiz shortly after and the reason for the visit was explained. Entrance interview conducted.

During today's visit, at 10:55 a.m., the LPA along with the ED conducted a plant tour to ensure there were no immediate health and safety concerns, conducted interviews with the ED, four staff, and six residents between 10:05 a.m. and 12:10 p.m., 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: 01/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2024

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-20240108164943

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: LAUREL HEIGHTS	FACILITY NUMBER: 565850243
	VISIT DATE: 01/16/2024

NARRATIVE

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(Report Continued from LIC 9099...)

It was alleged that the Administrator is not on the premises for a sufficient number of hours. It was reported that the Administrator is always away from the facility. Interviews conducted with staff revealed that the Administrator is seen coming into the facility everyday Monday through Friday. Staff stated that the Administrator typically comes in the morning and added that the Administrator leaves the facility after they have left for the day themselves. Additionally, during resident interviews it was revealed that six out of six residents often see the Administrator walking through the hallways talking with both residents and staff. Furthermore, interviews with residents and staff corroborated that the Administrator is regularly seen at the facility during normal business hours. Based on the interviews conducted with staff and residents, the Department does not have sufficient evidence to support the allegation of “administrator is not on the premises for a sufficient number of hours”. Therefore, this allegation is deemed Unsubstantiated at this time.

It was further alleged that a qualified staff is not designated to operate the facility during the administrator’s absence. It was reported that the facility has designated a receptionist to cover the facility in the Administrator’s absence and they are not qualified. Interviews conducted with staff revealed that the Administrator is regularly at the facility Monday through Friday. However, on weekends when the Administrator is not scheduled, there is management available at the facility. At any time, if the Administrator is unavailable, the facility has a Business Director, Health Services Director, and Marketing Director that are able to assist when needed. Furthermore, interviews conducted with staff revealed that management is available and willing to help whenever the Administrator is not present. Based on the information obtained and reviewed, the Department does not have sufficient evidence to support the allegation of “a qualified staff is not designated to operate the facility during the administrator’s absence”. Therefore, this allegation is deemed Unsubstantiated at this time.

Exit interview conducted. No citations issued at this time. A copy of the report was provided.

SUPERVISOR'S NAME: Desaree Perera	TELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Martha Arroyo	TELEPHONE: (818) 421-6459
LICENSING EVALUATOR SIGNATURE:	DATE: 01/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2024

LIC9099 (FAS) - (06/04)

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