567609954-3-8-2024-29-AS-ECOZ-D36P8Y-20240308100618

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 567609954
Report Date: 03/08/2024
Date Signed: 03/08/2024 10:06:51 AM

Document Has Been Signed on 03/08/2024 10:06 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

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
ADMINISTRATOR:	AMBER L WINTERSTEIN		FACILITY TYPE:	740
ADDRESS:	203 E EL ROBLAR DRIVE		TELEPHONE:	(805) 798-9305
CITY:	OJAI	STATE: CA	ZIP CODE:	93023
CAPACITY:	72	CENSUS: 36	DATE:	03/08/2024
TYPE OF VISIT:	Case Management - Incident	UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Jackie Sical		TIME COMPLETED:	10:10 AM

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	Allegation: Neglect/Lack of Care: Staff neglected and/or failed to provide an appropriate level of care resulting in Resident #1 (R1) being sexually abused by a family member. Licensing Program Analyst (LPA) Esther Cortez conducted a subsequent case management visit to deliver findings for the above allegation. LPA met with MedTech Alan Carrillo and explained the reason for the visit. Administrator Amber Winterstein was unable to be at the facility during today’s visit and authorized Care Director, Jackie Sical to sign and receive the report. On 11/18/2023, the Department received a Report of Suspected Dependent Adult/Elder Abuse Report from the facility. The report advised on 11/18/2023, Resident #1’s (R1) family member/Suspected Abuser (SA) was observed with their penis in R1’s mouth. On 11/20/2023, the Department referred the case to the Community Care Licensing (CCL) Investigations Branch (IB). The case was assigned to Investigator Christine Ferris to conduct the investigation in reference to the allegation. On 11/20/2023, from 1:50pm to 3:30pm, Licensing Program Analysts (LPAs) Elsie Campos and Emily Peraldi conducted an unannounced Case Management - Incident visit. At 1:55pm, LPAs Campos and Peraldi met with Administrator, Amber Winterstein and explained the reason for the visit. The reason for the visit was to follow up on a self-reported incident report received on 11/20/2023. The report pertained to a personal rights violation of Resident #1 (R1). At 1:58pm, the LPAs conducted an interview with the Administrator. At 2:06pm, the LPAs obtained copies of pertinent documents. At 2:55pm, the LPAs along with the Administrator conducted a physical plant tour. No immediate health and safety concerns were observed during the inspection. Report will continue on LIC809-C (2nd pg.).

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Esther Cortez	TELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 03/08/2024

NARRATIVE

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The LPAs determined further investigation was needed and informed the Administrator that the investigation was assigned to the Community Care Licensing (CCL) Investigations Branch (IB).

On 12/04/2023, from approximately 11:00am to 1:30pm, CCL IB Investigator Ferris conducted interviews with R1, Administrator, staff, and residents; on 12/19/2023, from approximately 11:30am to 1:00pm, with staff; on 01/19/2024 and 01/22/2024, attempted to contact the SA and left voice mails; and on 01/22/2024, at approximately 10:00am, with Detective Torres of the Ventura County Sheriff’s Department. In addition, Investigator Ferris requested Ventura County Sheriff’s Department Report #2023-147699 and facility file documents related to R1.

A review of R1’s Physician Report, dated 05/21/2023, lists R1’s primary diagnosis as end stage Cerebrovascular Disease with Dementia. The report also noted R1 was confused, disoriented with increased forgetfulness. R1’s health status was listed as poor. R1 required assistance with all activities of daily living and was receiving hospice care.

The investigation revealed that on 11/18/2023, at approximately 9:40am, facility Staff #1 (S1) stated they were delivering “punch cards” to the employee break room located in the southwest corner of the facility. The employee entrance opens into a long private pathway accessible to all residents and visitors. Located in the middle of the walkway was a bench. S1 turned the corner of the building to enter the break room and observed the SA standing over R1 with their penis is R1’s mouth. R1 was seated on the bench fully clothed facing the SA. S1 began yelling at the SA and walked towards them. As S1 got closer to them, the SA sat down on the bench beside R1 and S1 noticed the SA used their hands to cover their pants. S1 yelled at the SA for an explanation of what they witnessed, and the SA denied their actions. At approximately 9:42am, S1 used their radio to call for Staff #2 (S2) to come to the location and help get R1 back to their room. S1 told the SA to leave the location and when the SA stood, S1 noticed the SA’s pants were unzipped, and the SA’s belt was completely undone. S1 followed the SA until they left the facility. Once the SA was gone, S1 notified the supervisors and had R1 checked on.
Report will continue on LIC809-C (3rd pg.).

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Esther Cortez	TELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024

LIC809 (FAS) - (06/04)

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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: 03/08/2024

NARRATIVE

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S1 then contacted the Ventura County Sheriff’s Office who continued the investigation. The detectives attempted to interview R1, but R1 was unable to give a relevant statement. The detectives took the SA into custody and arrested the SA for PC 287(a) Forcible Oral Copulation and PC 368(b)(1) Elder abuse.

The Department’s investigation further revealed that the SA was a “trusted family member” who took R1 to their doctor’s appointments, therapy appointments, and visited R1 frequently. Upon witnessing the incident, the staff acted promptly to ensure R1’s safety and removed the SA from the location. S1 immediately reported the incident to the Administrator and the Ventura County Sheriff’s Department which resulted in the SA being arrested.

The Department’s investigation did not provide sufficient evidence to substantiate neglect/lack of care by the facility staff. Therefore, the allegation “Neglect/Lack of Care and Supervision” is deemed Unsubstantiated at this time.

Exit interview, copy of report given.

SUPERVISOR'S NAME: Kasandra Lopez	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Esther Cortez	TELEPHONE: (747) 230-2225
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2024

LIC809 (FAS) - (06/04)

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