Facility Evaluation Report

Licensing Program Analyst (LPA) De Leon conducted a subsequent case management visit to deliver final findings on this investigation. LPA met with Joni Chapman, Administrator and explained the purpose of the visit.

On 10/14/2024, the Woodland Hills North Adult and Senior Care Regional Office (RO) received a self- reported incident report (SIR) from the facility regarding Staff #1 (S1) physically abusing Client #1 (C1) while in care. The case was assigned to Investigator Romelia Munoz to investigate the allegation of physical abuse.

On 10/17/2024, from 11:57am to 2:38pm, Licensing Program Analyst (LPA) Mark Jeffries conducted an unannounced case management visit based on the SIR. The incident took place on 10/13/2024 at approximately 6:00pm. The SIR summarized that Client #1 (C1) sustained a serious injury, due to suspected abuse by Staff #1 (S1). LPA Jeffries conducted an interview with the Administrator Joni Chapman, observed and recorded the video of the 10/13/2024 incident, and requested documents pertinent to the investigation. The Administrator stated that S1 was put on suspension and notified of termination on 10/15/2024. During the visit, the Administrator completed the “Suspected Dependent Adult/Elder Abuse Report” (SOC341 form) and notified local law enforcement of the suspected abuse of C1 by S1.

On 10/24/2024, from approximately 11:45am to 1:45pm, Investigator (Inv.) Munoz conducted an interview with the Administrator, and attempted to interview two other clients, who were unable to comprehend or answer questions; all other clients were noted to be non-verbal, and investigator was unable to conduct interviews. Inv. Munoz also conducted the following interviews: on 11/14/2024 at approximately 3:30pm San Luis Obispo (SLO) County Sheriff’s office detective; on 11/26/2024, at approximately 2:00pm, attempted an interview with S1 and left message; on 12/03/2024, sent S1 a letter via certified mail requesting a contact (numerous attempts were made to contact S1, however, S1 did not contact the investigator); and on 12/05/2024, at approximately 12:16pm, with another facility staff.