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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610327
Report Date: 12/05/2024
Date Signed: 12/05/2024 02:24:08 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
11/21/2024 and conducted by Evaluator Michael Cava
COMPLAINT CONTROL NUMBER: 31-AS-20241121154006
FACILITY NAME:HAVEN HOMESFACILITY NUMBER:
197610327
ADMINISTRATOR:HOROWITZ, JESSICAFACILITY TYPE:
740
ADDRESS:10507 ANDASOL AVETELEPHONE:
(818) 324-7536
CITY:GRANADA HILLSSTATE: CAZIP CODE:
91344
CAPACITY:6CENSUS: 3DATE:
12/05/2024
UNANNOUNCEDTIME BEGAN:
11:48 AM
MET WITH:Jessica HorowitzTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not safeguard resident's personal possessions while in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPAs) Nadia Shahbazian and Michael Cava conducted a subsequent visit to the facility to close out the investigation regarding the above allegation. LPAs met with the administrator, Jessica Horowitz, and advised her of the complaint. Today's investigation consisted of interviews with the administrator, staff and residents. LPAs also conducted a record review and physical plaint inspection.

In regards to the allegation, it was reported that while Resident 1 (R1) lived at this facilty, some of their personal money went missing. Interviews with the administrator reveal that the facility does not handle resident cash. Administrator stated she did file an Incident Report (IR), pertaining to R1 missing money on or around March 22, 2024. R1's responsible person was notified, and the administrator filed a police report. Law Enforcement were unable to file a report since there was no evidence or proof of the exact amount taken. According to the administrator, she had no knowledge that R1 was keeping cash with them in their room, as it was never reported to her. Moreover, R1 never made an entry on their Client/Resident Personal
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
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-20241121154006
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: HAVEN HOMES
FACILITY NUMBER: 197610327
VISIT DATE: 12/05/2024
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
Property and Valuables (Form LIC 621). Review of R1's file reveal that this incident was reported by the administrator on 03/22/24. Further review of R1's file also confirm that R1 did not make an entry on their LIC 621 for cash. Interviews with residents also do not corroborate with the allegation of staff failing to safeguard their personal belongings.

Based on the information obtained, there was insufficient evidence to prove that staff did not safeguard R1's personal possession while in care. Therefore, the allegation is deemed Unsubstantiated at this time.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 12/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2