567609954-9-5-2023-29-AS-KBUY-CW32EN-20230926172011

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 567609954
Report Date: 07/05/2023
Date Signed: 09/05/2023 01:50:26 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS NORTH, 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
04/07/2023 and conducted by Evaluator Brian Phillips

PUBLIC

COMPLAINT CONTROL NUMBER: 29-AS-20230407163919

FACILITY NAME:	ARTESIAN OF OJAI, THE		FACILITY NUMBER:	567609954
ADMINISTRATOR:	MICHAEL O'NEILL		FACILITY TYPE:	740
ADDRESS:	203 E EL ROBLAR DRIVE		TELEPHONE:	(805) 798-9305
CITY:	OJAI	STATE: CA	ZIP CODE:	93023
CAPACITY:	72	CENSUS: 42	DATE:	07/05/2023
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Michael O'Neill, Administrator		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Facility staff did not safeguard residents’ belongings.
Facility does not provide special diets to resident as prescribed.
Facility staff did not assist with arranging transportation for resident.
Facility staff did not assist with arranging residents’ medical appointments.

INVESTIGATION FINDINGS:

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This is an amended report. Licensing Program Analyst (LPA) Brian Phillips conducted an unannounced subsequent complaint visit on 07/05/2023 to issue final findings for the allegations above. LPA arrived at the facility and announced the purpose of the visit. LPA met with Mike O’Neill, Administrator.

On the allegation: Facility staff did not safeguard residents’ belongings. It is alleged that staff members took a bag from a resident’s room containing cash and credit cards. The allegation states that upon return of the bag, cash was missing and $500 was spent from the resident’s debit account.

On 04/13/2023, LPA obtained and reviewed the facility Plan of Operation regarding Handling of Client Money as well as the Personal Property/Theft and Loss Policy. The Plan of Operation states that the facility will not hold personal funds for residents and discourages the keeping of jewelry, documents, large sums of money, or other items considered to be of value on site. Continued on 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Brian Phillips	TELEPHONE: (805) 956-1636
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2023

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-20230407163919

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS NORTH, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: ARTESIAN OF OJAI, THE	FACILITY NUMBER: 567609954
	VISIT DATE: 07/05/2023

NARRATIVE

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This is an amended report. Reasonable effort will be made to safeguard residents' non-monetary property and valuables, but the community cannot guarantee that items will not be lost or taken. The facility is covered by general liability insurance, but this insurance does not cover any property belonging to residents. Residents are encouraged to carry personal property insurance to cover any loss due to fire, theft, or other casualty. A general inventory of personal belongings will be conducted at time of move-in, but the facility is not responsible for any loss of money, jewelry, or other valuables. Residents are encouraged to leave valuables/money with family members or in a bank. No witnesses interviewed indicated seeing staff take any resident property from any resident room at any time. The facility does not maintain LIC621 Client/Resident Personal Property and Valuables documentation. The facility does not maintain LIC405 Record of Client’s/Resident’s Safeguarded Cash Resources documentation. Theft of resident belongings/money will be documented and upon request by the resident, theft and loss records will be made available to governmental and law enforcement agencies. In this instance, the resident did not request any action taken on the part of the facility according to the Personal Property/Theft and Loss Policy. R1 stated to LPA that they did not have a record of the $500 missing from the debit account. The facility was unaware of the alleged missing money of R1, and all Staff members interviewed by LPA were unaware of any Staff member or resident stealing money and/or taking any resident’s bag.

Based on the information obtained, there was insufficient evidence to prove the allegation. Therefore, the allegation is deemed Unsubstantiated at this time.

On the allegation: Facility does not provide special diets to resident as prescribed. It is alleged that the facility will not provide custom meals to residents with special diets.

The facility has a weekly set menu for Breakfast, Lunch, and Dinner for the residents. Snacks are available upon request. LPA received documentation of this menu, toured the kitchen, and observed meal service for residents. Special nutritional accommodations can be made for residents with medical necessitation provided by their physician. There is evidence that the resident in question has a required medical need for a special diet provided by the facility. According to the Physician Report of R1, there are no food allergies for R1, but R1 has a special diet of No Concentrated Sweets (NCS) and no sugars. According to the facility, special accommodations are made for R1 due to medical necessitation provided by R1’s physician. The Medication Administration Report (MARS) and Emergency Information Documentation for R1 which both had documentation of the Special Diet of NCS and no sugars provided by R1’s physician. Continued on 9099-C

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Brian Phillips	TELEPHONE: (805) 956-1636
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 29-AS-20230407163919

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS NORTH, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: ARTESIAN OF OJAI, THE	FACILITY NUMBER: 567609954
	VISIT DATE: 07/05/2023

NARRATIVE

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This is an amended report. Based on the information obtained, there was insufficient evidence to prove the allegation. Therefore, the allegation is deemed Unsubstantiated at this time.

On the allegation: Facility staff did not assist with arranging transportation for resident. It is alleged that the facility will not provide transportation for residents.

On 04/13/2023, LPA obtained and reviewed the facility Plan of Operation regarding transportation of residents. The Plan of Operation states transportation of residents will be provided to residents by a van/car to medically related appointments and to activities as outlined on the activity schedule. Transportation to non-medically related appointments will be provided if transport is available or by arrangement with a local transportation service with five transport vehicles. Additionally, internet and technological application-based transport services can be used for more independent residents. All residents interviewed at the facility described being helped into transportation to attend activities or shopping/etc.

Based on the information obtained, there was insufficient evidence to prove the allegation. Therefore, the allegation is deemed Unsubstantiated at this time.

On the allegation: Facility staff did not assist with arranging residents’ medical appointments. It is alleged that the facility will not help residents arrange medical appointments.

On 04/13/2023, LPA obtained and reviewed the facility Plan of Operation Response to Changes in Behavior or Medical Emergencies. In the event a resident's behavior or condition changes the resident's Attending Physician, family members and responsible parties will be notified.

In the event of an emergency, 911 will be called and the resident's Attending Physician, family members and responsible parties will be notified. Depending on the type of medical need, the responding paramedics will transport the patient to the local Hospital, or for more acute care cases, to the larger Community Memorial Hospital out of the area. Reporting Party (RP) alleged that the pharmacy could not fill a prescription immediately, but 911 was called & the resident was taken to the emergency room. Therefore, medical assistance was arranged and obtained by the facility for the resident. The statements by the RP about the pharmacy not being able to fill the medication do not match the allegation about the facility not assisting with medical appointments.

Based on the information obtained, there was insufficient evidence to prove the allegation. Therefore, the allegation is deemed Unsubstantiated at this time. Continued on 9099-C

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Brian Phillips	TELEPHONE: (805) 956-1636
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 29-AS-20230407163919

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS NORTH, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: ARTESIAN OF OJAI, THE	FACILITY NUMBER: 567609954
	VISIT DATE: 07/05/2023

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32	This is an amended report. Exit Interview conducted, copy of report provided to the Administrator of the facility.

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Brian Phillips	TELEPHONE: (805) 956-1636
LICENSING EVALUATOR SIGNATURE:	DATE: 09/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/05/2023

LIC9099 (FAS) - (06/04)

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