Complaint Investigation Report

197609631-1-25-2024-31-AS-TAGD-D8HNT2-20240826104401

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

01/23/2024 and conducted by Evaluator Jose Gary Tan

COMPLAINT CONTROL NUMBER: 31-AS-20240123093103

Staff are not following resident's dietary plan

Licensing Program Analysts (LPAs) Gary Tan and Michael Cava conducted an unannounced initial complaint visit at this facility to investigate the above allegations. LPAs met with administrator Itzel Guevarra and explained the reason for the visit.

LPAs conducted physical plant tour at 11:35 AM, requested copies of facility documents relevant to the investigation at 12:02 PM and interviewed staff and resident between 12:20 PM to 1:45 PM. Regarding the allegation that Staff are not following resident's dietary plan, it was alleged that staff are ignoring Resident #1 (R1)'s dietary restriction is being ignored by the staff. LPAs' record review at 12:15 PM revealed R1 had no dietary restriction on record for the last four (4) years. LPAs' interview with R1 also revealed that R1 was aware that R1 had no dietary order from a physician. Based on the information gathered during this visit. The allegation is deemed unsubstantiated at this time.

Exit interview conducted. Copy of this report issued.