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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 567609954
Report Date: 07/16/2025
Date Signed: 07/16/2025 04:59:00 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 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
05/14/2025 and conducted by Evaluator Teresa Camara
COMPLAINT CONTROL NUMBER: 29-AS-20250514132340
FACILITY NAME:ARTESIAN OF OJAI, THEFACILITY NUMBER:
567609954
ADMINISTRATOR:DAVID SCARLETTFACILITY TYPE:
740
ADDRESS:203 E EL ROBLAR DRIVETELEPHONE:
(805) 798-9305
CITY:OJAISTATE: CAZIP CODE:
93023
CAPACITY:72CENSUS: 36DATE:
07/16/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Andrea DavisTIME COMPLETED:
05:20 PM
ALLEGATION(S):
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Licensee does not ensure staff have proper fingerprint clearances
Staff are not dispensing medications as prescribed.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Teresa Camara and Kelly Dulek conducted a subsequent complaint investigation visit regarding the above noted allegations. LPAs met with Marketing Director Andrea Davis who is a designated facility representative (Designee) and explained the reason for the visit.
At 2:14 p.m. LPA Dulek reviewed staff files and found that Staff 1 (S1) has a fingerprint clearance with an exemption, however S1 is not associated to this facility. S1 was hired in April 2025. At 3:21 p.m. LPA Camara conducted a medication audit and found most of the medications reviewed appeared to be given as prescribed. However, Resident 1 (R1) and Resident 2 (R2) both had medications in bubble packs that appeared to not be given as prescribed, likely due to a documentation error. LPA also observed the start dates for medications were not consistently noted on the Centrally Stored Medication and Destruction Records. Based on records reviewed, the above noted allegations are deemed SUBSTANTIATED at this time.

Pursuant to Title 22 Division 6 Chapter 8 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 9009-D): Exit interview conducted, todays reports and appeal rights were reviewed and issued.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2025
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 4
Control Number 29-AS-20250514132340
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: ARTESIAN OF OJAI, THE
FACILITY NUMBER: 567609954
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/16/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/16/2025
Section Cited
CCR
87355(e)(4)
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(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1569.17(b) shall prior to working, residing or volunteering in a licensed facility: (4) Request and be approved for a transfer of a criminal record exemption, as specified in Section 87356(r), unless, upon request for a transfer, the Department permits the individual to be employed, reside or be present at the facility.
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Licensee will ensure S1 does not work at the facility until the criminal record exemption is approved for transfer and S1 is associated to this facility.
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Based on records reviewed, the facility did not comply with the above cited section, as S1 is not associated to this facility, which poses an immediate health and safety risk to persons in care.
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Type A
07/24/2025
Section Cited
CCR
87465(a)(4)
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(a) A plan for incidental medical and dental care shall be developed by each facility. The plan shall encourage routine medical and dental care and provide for assistance in obtaining such care, by compliance with the following: (4) The licensee shall assist residents with self-administered medications as needed.
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Licensee will provide training to all staff who handle medications on or before 7/24/2025. Evidence of training will be provided to CCL by 7/24/2025.
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Based on records reviewed, the facility did not comply with the above cited section, as medications for R1 and R2 were not properly documented, which poses an immediate health and safety risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 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
05/14/2025 and conducted by Evaluator Teresa Camara
COMPLAINT CONTROL NUMBER: 29-AS-20250514132340

FACILITY NAME:ARTESIAN OF OJAI, THEFACILITY NUMBER:
567609954
ADMINISTRATOR:DAVID SCARLETTFACILITY TYPE:
740
ADDRESS:203 E EL ROBLAR DRIVETELEPHONE:
(805) 798-9305
CITY:OJAISTATE: CAZIP CODE:
93023
CAPACITY:72CENSUS: 36DATE:
07/16/2025
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Andrea DavisTIME COMPLETED:
05:20 PM
ALLEGATION(S):
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Staff do not ensure facility appliances are repaired
Staff are not properly addressing pest infestation in the facility
Staff do not ensure hot water can be accessed throughout the facility to residents
Staff are not providing residents with reasonable level of privacy in their bedrooms
Staff are not mitigating the spread of infectious outbreaks in the facility
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Teresa Camara and Kelly Dulek conducted a subsequent complaint investigation visit regarding the above noted allegations. LPAs met with Marketing Director Andrea Davis who is a designated facility representative (Designee) and explained the reason for the visit.

LPAs conducted interviews with staff starting at 10:16 a.m. LPAs conducted facility tour at 10:56 a.m. At 3:21 p.m. LPA interviewed resident.

Regarding the allegation "Staff do not ensure facility appliances are repaired": This allegation was specifically regarding coffee machines, hot water dispensers, and ice machines. The facility has replaced the coffee machines and hot water dispensers. The ice machines have been repaired several times but the facility will be replacing the machines soon. In the meantime, the facility receives ice deliveries or they purchase ice from the grocery store if necessary between deliveries. This allegation is deemed UNSUBSTANTIATED at this time.


Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 29-AS-20250514132340
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: ARTESIAN OF OJAI, THE
FACILITY NUMBER: 567609954
VISIT DATE: 07/16/2025
NARRATIVE
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(continued from LIC9099A)

Regarding the allegation "Staff are not properly addressing pest infestation in the facility": Staff who were interviewed stated they had seen one or two roaches in one of the buildings. The facility immediately contacted a pest control company who addressed the issue on 5/29/2025 and 6/4/2025. There have not been any insects or vermin observed in the facility. The residents interviewed stated they had not observed any pests at the facility. This allegation is deemed UNSUBSTANTIATED at this time.

Regarding the allegation "Staff do not ensure hot water can be accessed throughout the facility to residents": LPAs conducted water temperature samples in all of the facility's buildings and the temperatures were within the regulatory range of 105*F - 120*F. This allegation is deemed UNSUBSTANTIATED at this time.

Regarding the allegation "Staff are not providing residents with reasonable level of privacy in their bedrooms": This allegation was specifically regarding staff going into residents' rooms without knocking. Staff and residents interviewed stated staff always knock before entering their rooms. This allegation is deemed UNSUBSTANTIATED at this time.

Regarding the allegation "Staff are not mitigating the spread of infectious outbreaks in the facility": This allegation was specifically regarding a number of residents who experienced gastrointestinal issues in May 2025. The facility's Resident Care Director was concerned there may be a Norovirus outbreak, utilized infection control practices and contacted Ventura County Public Health (VCPH) who came to the facility to evaluate the residents. Norovirus was not found in any of the residents and VCPH stated the outbreak was contained and they closed their case. This allegation is deemed UNSUBSTANTIATED at this time.

Exit interview conducted, today's reports and appeal rights were reviewed and issued.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Teresa Camara
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4