195850091-10-17-2024-29-AS-KHEN-DBEV8J-20241127151243

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 195850091
Report Date: 10/17/2024
Date Signed: 10/17/2024 06:18:53 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/30/2024 and conducted by Evaluator Angela Barutyan

COMPLAINT CONTROL NUMBER: 29-AS-20240830143412

FACILITY NAME:	PRESERVE AT WOODLAND HILLS, THE		FACILITY NUMBER:	195850091
ADMINISTRATOR:	MICHAEL OWENS		FACILITY TYPE:	740
ADDRESS:	6221 FALLBROOK AVENUE		TELEPHONE:	(747) 226-5834
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91367
CAPACITY:	60	CENSUS: 35	DATE:	10/17/2024
		UNANNOUNCED	TIME BEGAN:	04:00 PM
MET WITH:	Susan Weisbarth		TIME COMPLETED:	06:30 PM

ALLEGATION(S):

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Staff overmedicate resident(s) in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angela Barutyan arrived at the facility unannounced to conduct a subsequent complaint investigation for the allegation listed above at 04:00PM. LPA met with Health and Services Director (HSD) Antonio Nunez and Executive Director (ED) Susan Weisbarth and explained the reason for the visit.

During today's visit, LPA interviewed ED and HSD between 04:02PM - 6:00PM, reviewed and obtained copies of pertinent documents, conducted a brief physical plant tour with ED at 04:47PM, and interviewed two (2) residents and one (1) visitor between 04:49PM - 05:05PM. During the initial complaint visit which took place on 09/04/2024, LPAs Barutyan and K. Dulek reviewed records, conducted interviews, conducted a brief physical plant tour, conducted a medication review, and reviewed and obtained copies of pertinent documents.
Continued on LIC 9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20240830143412

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS N.ASC, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: PRESERVE AT WOODLAND HILLS, THE	FACILITY NUMBER: 195850091
	VISIT DATE: 10/17/2024

NARRATIVE

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It was alleged that staff overmedicated a resident in care. LPAs Barutyan and Dulek conducted a medication review of five (5) residents on 09/04/2024 and observed all medications being given as prescribed. Medications are stored, documented, and administered in accordance with California Code of Regulations, Title 22 and state and federal law. Interviews with the reporting party (RP) indicated concerns of medication dosages that were being administered to Resident #1 (R1) and medication-technicians administering painkillers that were “too strong.” Interviews with staff and ED Willis revealed that the painkillers were prescribed by R1’s physician and that the med-techs were administering the prescribed medications per the medication instructions on the Rx label, which is consistent with LPA observation during the medication audit. The RP also stated that R1 was “numbed and dazed” from the strength of the painkillers and that the med-techs should not have administered that strong of a dosage. Per regulation, med-techs do not need to be licensed medical professionals and therefore, cannot alter or prescribe medications. Medication review indicated that family of R1 provide over-the-counter nutrients, supplements, and medications like “fear spray” and “calming essential oils” which med-techs stated they do not know how to use as R1 cannot verbally or physically express if they are scared. ED Willis stated that they are worried that assuming how R1 is feeling and administering something that R1 cannot consent to is a violation of personal rights. LPAs Barutyan and Dulek did not observe any medication errors for five (5) residents reviewed on 09/04/2024 and for four (4) residents reviewed on 08/13/2024 by LPAs Barutyan and Emily Peraldi. LPA telephonically interviewed the co-complainant on 10/14/2024 who stated that the allegation was “inaccurate” and that they do not believe the staff are over-medicating. Co-complainant did not have any information to support the allegation. Based on interviews, medication review, and record review, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may be valid, at this time there is insufficient evidence to support the allegation or that a violation occurred, therefore, the allegation “Staff overmedicate resident(s) in care” is deemed UNSUBSTANTIATED at this time.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2024

LIC9099 (FAS) - (06/04)

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