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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 567609834
Report Date: 03/22/2024
Date Signed: 03/22/2024 03:04:42 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
10/04/2023 and conducted by Evaluator Martha Arroyo
COMPLAINT CONTROL NUMBER: 29-AS-20231004101628
FACILITY NAME:BCBN LLC EFACILITY NUMBER:
567609834
ADMINISTRATOR:FARRUGGIA, FABIANAFACILITY TYPE:
735
ADDRESS:2244 GLORYETTE AVETELEPHONE:
(805) 285-0294
CITY:SIMI VALLEYSTATE: CAZIP CODE:
93063
CAPACITY:4CENSUS: 4DATE:
03/22/2024
UNANNOUNCEDTIME BEGAN:
02:25 PM
MET WITH:Florencia FarruggiaTIME COMPLETED:
03:10 PM
ALLEGATION(S):
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Facility staff are violating client’s personal rights.
Facility staff are not providing dinner to clients.
Facility staff are not following client's special diet orders.
Facility staff failed to assist client's with self-administration of medications.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Martha Arroyo conducted a subsequent complaint visit to the above facility. The purpose of the visit is to deliver findings for the above allegations. LPA M. Arroyo and Tri-Counties Regional Center Quality Assurance Specialist (QAS) Ryan Landseadel conducted an initial complaint visit on 10/10/2023, and a subsequent visit on 11/03/2023. On today's visit, LPA Arroyo met with Administrator, Florencia Farruggia. Entrance interview.

During the initial visit on 10/10/2023, LPA Arroyo and QAS Landseadel conducted an interview with the Administrator at 3:50 p.m., conducted a file review at 4:00 p.m., and obtained copies of pertinent documents. On 11/03/2023, LPA Arroyo and QAS Landseadel conducted interviews with two staff members and the Licensee Representative between 3:45 p.m. and 5:00 p.m. and obtained copies of pertinent documents. On 11/02/2023, LPA Arroyo and QAS Landseadel conducted a collateral visit at Advanced Adult Day Health Care and conducted interviews with three (3) clients at 9:18 a.m., 9:30 a.m., and 9:56 a.m.
Continued on LIC 9099C...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2024
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 3
Control Number 29-AS-20231004101628
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: BCBN LLC E
FACILITY NUMBER: 567609834
VISIT DATE: 03/22/2024
NARRATIVE
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Continued from LIC 9099...

It was alleged that facility staff are violating client’s personal rights. It was reported that staff are not allowing Client #1’s (C1’s) friends at the facility. Records review of C1’s admissions agreement signed on 09/01/2019, states on page 2 under Facility Visiting Policy, that “your visitors are allowed from 9AM till 7PM, and if you want other time, please let us know so we can make the proper arrangements to not interrupt others privacy too”. Interviews conducted with staff revealed that family often visit the clients at home, as well as friends to hangout from time to time. Additionally, during an interview with C1’s friend, they denied ever visiting C1 and being refused entry into the home. Furthermore, three (3) out of three (3) clients reported having visitors while living at the facility. It was also reported that clients are not allowed to hangout or watch television in the living room after dinner. During interviews, the Administrator stated that clients are able to come outside whenever and hang out in the living room and watch television, but lately the clients rather go to their rooms and play or talk on their phones. Interviews conducted with clients revealed that they like to rest in their rooms after dinner and watch television with their roommate. Additionally, client denied being told by staff that they were not allowed to be in the living room. It was further reported that staff is refusing the clients from returning home after the day program ends on Thursdays. Interviews conducted with clients revealed that on Thursdays after day program, they like to volunteer in the community at the library and go bowling with their friends. Based on the information during the course of the investigation, the Department does not have sufficient evidence to support the allegation of “facility staff are violating client’s personal rights”. Therefore, this allegation is being deemed Unsubstantiated at this time.

It was also alleged that facility staff are not providing dinner to client. It was reported that clients are being told by staff to bring home half their lunch that is provided by the day program home to have at home as their dinner. Interviews conducted with facility staff revealed that clients are provided lunch during day program. Staff stated that clients will at times bring their leftovers from day program saying they did not want to throw it away and want to have it later as a snack; however, staff stated that dinner is cooked for the clients every day unless they go out to eat for dinner. Staff added that dinner is usually provided at around 6:00 p.m., and then the clients will go out on an outing. Interviews conducted with clients revealed that leftovers are taken home after day program because they do not want to waste food and know they will get hungry soon after.

Continued on LIC 9099C...

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 29-AS-20231004101628
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: BCBN LLC E
FACILITY NUMBER: 567609834
VISIT DATE: 03/22/2024
NARRATIVE
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Continued from LIC 9099C...
Additionally, during interviews, clients denied facility staff asking them to bring their leftovers home after day program. Furthermore, clients stated that facility staff provide dinner every day including all meals during the weekends. Based on interviews conducted with facility staff and clients, the Department does not have sufficient evidence to support the allegation of “facility staff are not providing dinner to client”. Therefore, this allegations is being deemed Unsubstantiated at this time.

It was also alleged that staff are not following client’s special diet orders. It was reported that C1 is under doctor’s orders not to eat salads or uncooked vegetables and staff are ignoring C1’s dietary restrictions. Records review revealed that C1 was recommended to follow the Small Intestine Bacterial Overgrowth (SIBO) diet. Interviews conducted with staff revealed that C1 was recommended to follow the SIBO diet and cannot eat raw vegetables. Staff stated that whenever salads are prepared for the clients, they make sure the vegetables are cooked for C1 and added that everything that they prepare for all the clients is fully cooked. Additionally, staff added that C1’s family had also communicated with facility staff to make sure all vegetables were being cooked for C1. Furthermore, during client interviews, clients did not express or report concerns with the food being cooked and provided by the facility. Based on interviews conducted with facility staff and clients, the Department does not have sufficient evidence to support the allegation of “staff are not following client’s special diet orders”. Therefore, this allegation is being deemed Unsubstantiated at this time.

It was further alleged that facility staff failed to assist client with self-administration of medications. It was reported that C1 has been denied migraine medication as well as the use of their inhaler and allergy medication. Interviews conducted with facility staff revealed that C1 has come home with PRNs prescribed by other doctors that are not C1’s Primary Care Physician (PCP). Staff stated that they contact C1’s PCP to advise them of the medications C1 is bringing home so that C1’s PCP is aware as well. Staff stated that all routine medications are given as they should and added that C1 is able to ask for PRN medications if needed. Interviews conducted with clients revealed that their medication is given to them every day. Furthermore, during an interview with C1, C1 stated that they have a PRN for migraines; however, C1 stated that they have not had any migraines in a long time and therefore have not asked for it. Based on the information obtained and reviewed, the Department does not have sufficient evidence to support the allegation of “facility staff failed to assist client with self-administration of medications”. Therefore, this allegation is being deemed Unsubstantiated at this time.

Exit interview conducted. Report was reviewed and copy was issued.

SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Martha Arroyo
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3