<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609011
Report Date: 09/10/2024
Date Signed: 09/10/2024 04:22:06 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/03/2024 and conducted by Evaluator Evelin Rios
COMPLAINT CONTROL NUMBER: 31-AS-20240103165416
FACILITY NAME:STRAWBERRY COTTAGEFACILITY NUMBER:
197609011
ADMINISTRATOR:TAYLOR, DAVID JAMESFACILITY TYPE:
740
ADDRESS:43732 SENTRY LANETELEPHONE:
(661) 266-7995
CITY:LANCASTERSTATE: CAZIP CODE:
93536
CAPACITY:6CENSUS: 5DATE:
09/10/2024
UNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Monica Gory (Administrator)TIME COMPLETED:
04:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff does not provide nutritious meals.
Staff does not provide an adequate amount of food.
Resident’s toilet is in disrepair.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 09/10/2024 Licensing Program Analyst (LPA) Evelin Rios arrived at the facility to conduct an unannounced subsequent visit to deliver the determination on the above allegations. LPA was greeted by Staff #4 (S4) who granted access. S4 contacted the administrator, Monica Gory to let them know LPA was at the facility. Administrator met LPA shortly after. LPA explained the purpose of the visit.

At 1:40 p.m. LPA conducted a physical plant tour to ensure the health and safety of the residents in care.
On 01/12/2024 LPA Rios conducted an unannounced initial complaint visit for the above allegations. During the initial visit LPA conducted a physical plant tour, interviews with staff #1 (S1), the administrator designee at the time Ricky De Sahagun and staff #2 (S2). LPA also conducted interviews with three (3) out of six (6) residents at the facility able to respond to LPA’s questions. LPA reviewed and obtained copies of the staff calendar, meal calendar and staff’s daily notes.
(Continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
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 3
Control Number 31-AS-20240103165416
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: STRAWBERRY COTTAGE
FACILITY NUMBER: 197609011
VISIT DATE: 09/10/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
On a subsequent visit on 2/12/2024 LPA conducted another physical plant tour, interviewed resident #1 (R1), and another resident not interviewed on the initial visit, staff #3 (S3), the administrator at the time David Taylor and administrator designee Monica Gory. During the subsequent visit LPA obtained copies of the staff calendar.

Allegation: Staff does not provide nutritious meals. It is alleged the food served is mostly canned and vegetables are not provided. To investigate this allegation LPA conducted a physical plant tour on 01/12/2024 and 02/12/2024 of the kitchen and garage where food is stored. LPA observed one (1) refrigerator and one (1) pantry in the kitchen and a second refrigerator with deep freezer in the garage. LPA observed a sufficient supply of two day perishable and seven day nonperishable food, such as vegetables, meats, eggs, fruit, bread, cans of beans, and soups. According to LPA’s interview with two (2) staff they revealed residents have their preference of food and they will try to cook various meals to satisfy what the resident likes to eat. According to both staff, resident #1 (R1) has a preference of what they like to eat, and it does not always include meals that are necessarily nutritious. Interview with staff and the administrator revealed that R1 has purchased their own groceries such as frozen dinners and meats because they do not like what is served at the facility. Both staff deny not providing residents with options or nutritious meals. According to the administrator, David Taylor the menu has been updated to include residents’ preferences. LPA’s interview with resident #1(R1) revealed they purchase their own groceries because the facility does not provide nutritious meals and they do not like staff's cooking. LPA’s interview with resident #2 (R2) revealed they will sometimes have to “force” staff to provide vegetables, a starch and meat. R2 does not deny being provided the meals once requested. Interview with two other residents’ have no issues with the meals being provided. Based on interviews and observation although the allegation may have happened or is valid, there is insufficient evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed unsubstantiated at this time.

Allegation: Staff does not provide an adequate amount of food. It is alleged resident #1 (R1) has to purchase their own groceries because there is an inadequate amount of food at the facility. Interview with staff and the administrator revealed that R1 has purchased their own groceries because they do not like what is served at the facility. Both staff deny not providing residents with enough food when preparing their meals. (Page 2 of 3)

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 31-AS-20240103165416
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: STRAWBERRY COTTAGE
FACILITY NUMBER: 197609011
VISIT DATE: 09/10/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
LPA’s interview with resident #1 (R1) revealed they purchase their own groceries because the facility does not provide nutritious meals and there are not enough food options. Interview with three (3) out of six (6) residents revealed they have no issues with the amount of food provided for meals. Based on interviews and observation although the allegation may have happened or is valid, there is insufficient evidence to prove the alleged violation did or did not occur. Therefore, the allegation is deemed unsubstantiated at this time.

Allegation: Resident’s toilet is in disrepair. It was alleged the facility has a broken toilet seat. To investigate the allegation, LPA conducted a physical plant tour of three (3) out of three (3) bathrooms on 01/12/2024. On the initial visit LPA observed in one (1) of three (3) bathrooms a raised toilet seat secured to the toilet. According to LPA’s interview with Ricky De Sahagun the toilet seat was changed to assist residents with the use of the toilet and because they had received a complaint from resident #1 (R1) about the toilet seat. LPA’s Interview with R1 stated they purchased a toilet seat because the toilet seat was broken. According to facility notes obtained on 01/12/2024 it shows staff documented that R1 had complained about the toilet seat on 01/02/2024. LPA’s Interview with Ricky corroborates that R1 did purchase a toilet seat without informing staff or the administrator. Ricky went on to say the toilet seat currently being used is not the one R1 purchased and that they informed R1 to use the second bathroom while the facility addressed the issue. LPA could not find another witness to corroborate the toilet seat was broken. Based on LPA’s observation the toilet was not broken during time of visit and according to the facility they replaced the toilet seat based on a complaint made by R1 and not because it was broken. Therefore, the allegation is deemed unsubstantiated at this time.
Exit interview conducted. Copy of report provided.

(Page 3 of 3)

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Evelin Rios
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3