Complaint Investigation Report

197609683-6-8-2023-31-AS-TAGD-CUBMTK-20230802095341

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

05/31/2023 and conducted by Evaluator Jose Gary Tan

COMPLAINT CONTROL NUMBER: 31-AS-20230531134458

Uncleared adults providing care to residents

Licensing Program Analyst (LPA) Gary Tan conducted an unannounced complaint visit at this facility to investigate the above allegation. LPA met with Gio Monico and explained the reason for the visit.

LPA conducted physical plant tour at 9:12 AM, requested copy of documents relevant to the investigation at 9:40 AM and interviewed staff between 10:02 AM to 11:00 AM. LPA also conducted record review between 11:00 AM to 12:00 PM. It was alleged that three (3) staff are working at the facility without fingerprint clearance. LPA's record review today revealed that Staff #1 (S1) and Staff #2 (S2) worked at the facility with pending fingerprint clearance, Staff #3 however, has a fingerprint clearance on file. LPA interview with Assistant Administrator today at 10:02 AM revealed that these three (3) employees indeed worked here but was removed upon review of the Guardian system on 05/23/23 wherein their status still shows pending. S2 is currently completing exemption papers and so do S1 but S3 no longer works at the facility. Based on the information gathered during this visit, the allegation is deemed substantiated at this time. Citation issued, civil penalty assessed, appeal rights discussed and given. Copy of this report issued.