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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610151
Report Date: 12/06/2024
Date Signed: 12/06/2024 02:09:13 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
12/02/2024 and conducted by Evaluator Michael Cava
COMPLAINT CONTROL NUMBER: 31-AS-20241202110854
FACILITY NAME:AEGIS LIVING GRANADA HILLSFACILITY NUMBER:
197610151
ADMINISTRATOR:LANCE SHENKFACILITY TYPE:
740
ADDRESS:10801 LINDLEY AVETELEPHONE:
(818) 363-3373
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:100CENSUS: DATE:
12/06/2024
UNANNOUNCEDTIME BEGAN:
09:14 AM
MET WITH:Ticarra Boyd, Lance ShenkTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Staff left resident at the hospital unattended
Staff left resident in soiled diapers/clothing
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to the facility to investigate the above allegations. LPA met with the Regional Care Director (RCD), Ticarra Boyd, and advised her of the allegations. Executive Director (ED), Lance Shenk joined shortly after. Today's investigation consisted of interviews witht the RCD, staff, residents. LPA also conducted a physical plant inspection and conducted a record review.

Staff left resident at the hospital unattended:
In regards to the allegation, it was reported that Resident 1 (R1) was sent to the hospital on or around 11/27/24, and left unattended by staff. R1 is unable to speak or communicate their needs. Interviews with the wellness and care director, Staff 1 (S1) and Staff 2 (S2) deny the allegation, stating they would never leave a resident unattended when taken out into the community. In regards to R1, both S1 and S2 stated R1 was taken to the hospital under doctor's orders for kidney injury. R1's family made arrangements with a
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024
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 2
Control Number 31-AS-20241202110854
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: AEGIS LIVING GRANADA HILLS
FACILITY NUMBER: 197610151
VISIT DATE: 12/06/2024
NARRATIVE
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private ambulance company to transport R1 to the hospital, and gave specific instructions for the driver to stay with R1 until admission at the hospital. LPA interviewed R1's family, and they confirmed that the private ambulance company was given specific instructions to stay with R1 until staff at the hospital admits R1. R1's family stated this incident is at no fault of the facility, because of the arrangements made with the ambulance company. Moreover, family stated the driver from the ambulance company not only left R1 unattended, but dropped R1 at the wrong entrance at the hospital. LPA also conducted interviews with residents who do not corroborate with the allegation of ever being left unattended by staff during their medical appointments.

Based on the information obtained, there was insufficient evidence to prove that facility staff left R1 unattended at the hospital. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff left resident in soiled diapers/clothing:
In regards to the allegation, it was reported that when R1 was transported to the hospital, R1 was soiled or covered in their urine. The reporting party (RP) was unable to confirm if R1 left the facility dry, and had an accident while waiting for admission in the hospital, or if R1 had urinated on self in route to the hospital. There were no witnessed provided by the RP to corroborate if the facility staff allowed for R1 to leave the facility soiled in their clothes, in route to the hospital. Interviews with facility staff deny the allegation, stating, when R1 was picked up by the ambulance for hospitalization on 11/27/24, they were dry and not soiled in their clothing. R1 was assessed prior to departure to the hospital.

Based on the information obtained, there wasn't enough evidence to prove that staff left R1 soiled in the diapers or clothing. Therefore, the allegation is deemed Unsubstantiated at this time.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024
LIC9099 (FAS) - (06/04)
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