Complaint Investigation Report

197610318-3-29-2024-31-AS-EMIR-D8BSYC-20240820141720

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

03/20/2024 and conducted by Evaluator Jose Gary Tan

COMPLAINT CONTROL NUMBER: 31-AS-20240320145409

Staff are not allowing resident to leave the facility

Licensing Program Analyst (LPA) Gary Tan conducted an unannounced initial complaint visit at this facility to investigate the above allegation. LPA met with

LPA conducted physical plant tour at 9:15 AM, requested copies of facility documents relevant to the investigation at 9:33 AM and interviewed residents and staff between 10:30 AM to 11:40 AM. It was alleged that Resident #1 (R1) was not allowed to leave the facility with R1's Power of Attorney (POA) by the facility staff. LPA's record review today at 10:00 AM revealed that R1 was admitted at this facility on 05/23/23 and had revoked R1's POA on 01/27/2024. Further review also revealed that R1 was able to follow instruction and able to communicate own needs and does not have dementia diagnosis. LPA's interview with R1 revealed that R1 was aware that R1 revoked own POA and did not want to leave the facility. Based on the information gathered during this visit, the allegation is deemed unsubstantiated at this time.

Exit interview conducted. Copy of this report issued.