Complaint Investigation Report

197610237-5-14-2023-31-AS-RRAZ-CS4QAR-20230523120019

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

WOODLAND HILLS S.ASC , 21731 VENTURA BLVD., STE. 250

This is an official report of an unannounced visit/investigation of a complaint received in our office on

09/19/2022 and conducted by Evaluator Jose Gary Tan

COMPLAINT CONTROL NUMBER: 31-AS-20220919123009

Staff spoke inappropriately to other staff in the presence of resident(s) in care

Licensing Program Analyst (LPA) Gary Tan conducted an unannounced subsequent complaint visit at this facility to further investigate the above allegation. LPA initially met with staff Pauline Fiesta who called the administrator and explained the reason for the visit. Administrator arrived 30 minutes later.

LPA conducted physical plant tour at 10:35 AM, requested copy of facility documents relevant to the investigation at 11:00 AM and interviewed staff and residents between 11:15 AM to 2:30 PM. It was alleged that Staff #1 (S1) told Staff #2 (S2) to poison Staff #3 (S3). LPA's interview with five (5) staff today between 11:15 AM to 2:30 PM, revealed that the there was no incident in the facility wherein S1 told S2 to poison S3. LPA's interview with four (4) residents today between 11:15 AM to 2:30 PM revealed that no one among the four (4) residents experienced nor witness any staff mistreated or talk inappropriately to any resident. Based on the information gathered during this and prior visit, the allegation is deemed unsubstantiated at this time.

Exit interview conducted. Copy of this report issued.