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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197609931
Report Date: 08/30/2023
Date Signed: 08/30/2023 02:34:32 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 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
08/24/2023 and conducted by Evaluator Jose Gary Tan
COMPLAINT CONTROL NUMBER: 31-AS-20230824091140
FACILITY NAME:KAREN'S BOARD AND CARE, INCFACILITY NUMBER:
197609931
ADMINISTRATOR:ZINKOFSKY, CLARITAFACILITY TYPE:
740
ADDRESS:17231 TUBA STREETTELEPHONE:
(818) 216-3271
CITY:NORTHRIDGESTATE: CAZIP CODE:
91325
CAPACITY:6CENSUS: 4DATE:
08/30/2023
UNANNOUNCEDTIME BEGAN:
09:14 AM
MET WITH:CLARITA ZINKOFSKY - AdministratorTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Facility has roaches

Residents are treated inappropriately by staff
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Gary Tan and Christopher Alemoh conducted an unannounced initial complaint visit at this facility to investigate the above allegations. LPAs met with administrator Clarita Zinkofsky and explained the reason for the visit.

LPAs conducted physical plant tour at around 9:31 AM, requested copies of facility documents relevant to the investigation at 10:00 AM and interviewed staff and residents between 1:05 AM to 1:25 PM. Regarding the allegation that the facility has roaches, it was alleged that the roaches are roaming around the facility. LPAs physical plant tour at 9:31 AM revealed that LPAs did not observe any roach in all bedrooms or any area of the facility including bathrooms, crevices in the kitchen and other common rooms. LPAs' interview with two (2) aware residents between 10:05 AM to 12:30 PM revealed that both residents did not observe any roaches anywhere inside the facility. LPAs' interview with two (2) live in staff present also revealed that they did not observe any roaches in the facility at anytime. LPAs' interview with the administrator revealed that they regularly do insect control to avoid any kind of infestation and not have any roaches in the facility.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2023
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-20230824091140
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: KAREN'S BOARD AND CARE, INC
FACILITY NUMBER: 197609931
VISIT DATE: 08/30/2023
NARRATIVE
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(continued from LIC 9099-C)

Regarding the allegation that Residents are treated inappropriately by staff, it was alleged that staff told residents to "shut up", LPAs' interview with two (2) aware residents revealed that no staff spoke to them inappropriately or told them to "shut up" nor witnessed any staff told any other resident to "shut up" or spoke inappropriately and all of the staff are respectful to them at all times. Two (2) staff present also denied speaking inappropriately to any resident at any time during LPAs' interview between 10:00 AM to 12:30 PM. LPAs' interview with the administrator also revealed that she did not receive any report or complaint from any resident of any staff speaking inappropriately.

Based on the information gathered during this visit, the allegations are deemed unsubstantiated at this time.

Exit interview conducted. Copy of this report issued.
SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Jose Gary Tan
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3