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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 195850435
Report Date: 08/14/2024
Date Signed: 08/14/2024 05:49:47 PM

Substantiated


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
08/08/2024 and conducted by Evaluator Angela Barutyan
COMPLAINT CONTROL NUMBER: 29-AS-20240808112739
FACILITY NAME:TRUE LIVING CARE LLCFACILITY NUMBER:
195850435
ADMINISTRATOR:HAVSGAARD, CHRISTIANFACILITY TYPE:
740
ADDRESS:22740 HATTERAS STREETTELEPHONE:
(951) 580-7888
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91367
CAPACITY:6CENSUS: 4DATE:
08/14/2024
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Christian HavsgaardTIME COMPLETED:
05:50 PM
ALLEGATION(S):
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Staff are restraining residents in care by use of bedrails.
Staff do not afford privacy to residents in care.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Angela Barutyan and Zabel Chochian arrived at the facility unannounced to conduct an initial complaint investigation for the allegations listed above at 10:15AM. LPAs met with staff and Administrators/Licensee Vanessa Barcela and Christian Havsgaard and explained the reason for the visit.

During today's visit, LPAs conducted a brief physical plant tour at 10:20AM, interviewed 2 (two) residents between 10:47AM-11:06AM, the 2 (two) administrators between 11:40AM-12:25PM, and 1 (one) staff at 12:27PM, reviewed resident records, and reviewed and obtained copies of pertinent documents.

At approximately 12:15PM, LPAs discussed allegations with Licensee and Administrator.

Report Continued on LIC 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 6
Control Number 29-AS-20240808112739
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: TRUE LIVING CARE LLC
FACILITY NUMBER: 195850435
VISIT DATE: 08/14/2024
NARRATIVE
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It was alleged that staff are restraining residents in care by use of bedrails. The complainant alleged that 3 (three) residents are restrained by bedrails. LPAs observed full bedrails on Resident 1 (R1)’s bed at 10:22AM, half-rails on Resident 2 (R2)’s bed at 10:33AM, and half-rails on Resident 3 (R3)’s bed at 10:35AM. R1 is not on hospice and does not have an order for full bedrails; R2 and R3 do not have physician’s orders for half-rails. LPAs did not observe bedrails on Resident 4 (R4)’s bed at the time of the visit. Based on LPAs’ observation and record review, the allegation “staff are restraining residents in care by use of bedrails” is deemed SUBSTANTIATED at this time.

It was alleged that staff do not afford privacy to residents in care. The complainant alleged that the facility uses surveillance cameras in common areas where residents use personal computers and where meetings of resident and family groups occur. During physical plant tour, LPAs observed cameras throughout the common areas of the facility that are used for family visits and computer use. During administrator interview, it was confirmed at 12:01PM that the cameras have an auditory component and save short recordings with audio when movement is detected. Based on LPAs’ observation and interviews, the allegation “staff do not afford privacy to residents in care” is deemed SUBSTANTIATED at this time.

The following deficiencies were observed (See LIC 9099-D) and cited from the California Code of Regulations, Title 22 and/or California Health and Safety Code. Administrator was informed that failure to correct the deficiencies may result in civil penalties.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 29-AS-20240808112739
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: TRUE LIVING CARE LLC
FACILITY NUMBER: 195850435
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/14/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/15/2024
Section Cited
CCR
87608(a)(5)
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(a)Based on the individual's preadmission appraisal...Postural supports may be used under the following conditions. (5)Under no circumstances shall postural supports include tying, depriving, or limiting the use of a resident's hands or feet.
This requirement is not met as evidenced by:
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Administrator removed full bedrail during the time of the visit. Administrator will contact physicians for half-bedrail orders and submit proof to CCL by due date.
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Based on observation and record review, Licensee did not comply with section cited above. 1 (one) non-hospice resident had full bedrails and 2 (two) residents had half-rails with no physician orders. This poses an immediate health, safety and personal rights risk to persons in care.
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Type B
08/21/2024
Section Cited
CCR
87468.2(a)(1)
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(a)...residents in privately operated residential care facilities for the elderly shall have all of the following personal rights:(1) To have a reasonable level of personal privacy in...use of the Internet, and meetings of...family groups. This requirement is not met as evidenced by:
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Administrator removed cameras with auditory components during the time of the visit. Administrator will inform LPA of future plans to install cameras. POC is cleared.
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Based on observation and interviews, Licensee did not comply with section cited above in that cameras with auditory component were in common areas where residents use internet and have family visits. This poses a potential personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 6
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
08/08/2024 and conducted by Evaluator Angela Barutyan
COMPLAINT CONTROL NUMBER: 29-AS-20240808112739

FACILITY NAME:TRUE LIVING CARE LLCFACILITY NUMBER:
195850435
ADMINISTRATOR:HAVSGAARD, CHRISTIANFACILITY TYPE:
740
ADDRESS:22740 HATTERAS STREETTELEPHONE:
(951) 580-7888
CITY:WOODLAND HILLSSTATE: CAZIP CODE:
91367
CAPACITY:6CENSUS: 4DATE:
08/14/2024
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Christian HavsgaardTIME COMPLETED:
05:50 PM
ALLEGATION(S):
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Resident is not afforded safe, healthful, and comfortable accommodations.
Uncleared adults are providing care and supervision to residents.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Angela Barutyan and Zabel Chochian arrived at the facility unannounced to conduct an initial complaint investigation for the allegations listed above at 10:15AM. LPAs met with staff and Administrators/Licensee Vanessa Barcela and Christian Havsgaard and explained the reason for the visit.

During today's visit, LPAs conducted a brief physical plant tour at 10:20AM, interviewed 2 (two) residents between 10:47AM-11:06AM, the 2 (two) administrators between 11:40AM-12:25PM, and 1 (one) staff at 12:27PM, reviewed resident records, and reviewed and obtained copies of pertinent documents.

At approximately 12:15PM, LPAs discussed allegations with Licensee and Administrator.

Report Continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 29-AS-20240808112739
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: TRUE LIVING CARE LLC
FACILITY NUMBER: 195850435
VISIT DATE: 08/14/2024
NARRATIVE
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It was alleged that resident is not afforded safe, healthful, and comfortable accommodations. The complainant alleged that R2 requests air conditioning in their bedroom, but the facility refuses to turn it on in order to save money. LPAs observed a cool temperature of 72 degrees Fahrenheit in the facility and R2’s bedroom. LPAs interviewed residents and found that residents are satisfied with the temperature of the facility. No issues or concerns were observed during resident interviews regarding comfortable accommodations. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “resident is not afforded safe, healthful, and comfortable accommodations” is deemed UNSUBSTANTIATED at this time.

It was alleged that there are uncleared adults providing care and supervision to residents in the facility. All staff present at the facility during the time of the visit had fingerprint and background clearance and were associated to the facility. Based on the information obtained during the investigation, the Department does not have sufficient evidence to corroborate the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the above allegation “uncleared adults are providing care and supervision to residents” is deemed UNSUBSTANTIATED at this time.

SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Angela Barutyan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 6