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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565800551
Report Date: 05/03/2024
Date Signed: 05/03/2024 03:34:37 PM

Unsubstantiated


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
02/01/2024 and conducted by Evaluator Esther Cortez
COMPLAINT CONTROL NUMBER: 29-AS-20240201103428
FACILITY NAME:GABLES OF OJAI, THEFACILITY NUMBER:
565800551
ADMINISTRATOR:MATTEO DIGRIGOLIFACILITY TYPE:
740
ADDRESS:701 N. MONTGOMERY ST.TELEPHONE:
(805) 646-1446
CITY:OJAISTATE: CAZIP CODE:
93023
CAPACITY:118CENSUS: 76DATE:
05/03/2024
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Matteo DigrigoliTIME COMPLETED:
03:40 PM
ALLEGATION(S):
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Facility staff are retaining a resident requiring a higher level of care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Esther Cortez conducted a subsequent complaint visit for the above allegation. Upon arrival, LPA met with the Executive Director (ED), Matteo DiGrigoli and was explained the reason for the visit. Entrance interview conducted.

On 2/08/2024, between 09:45 a.m. and 12:00 p.m., the LPA conducted an initial compalint visit, interviewed the Administrator, Resident #1 (R1), R1's private caregiver, conducted a file review, and obtained copies of resident records and other pertinent documents relevant to the investigation. During today's visit the LPA conducted one (1) staff interview, and reviewed records collected during the initial complaint visit.

Report will continue on LIC9099-C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024
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 29-AS-20240201103428
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: GABLES OF OJAI, THE
FACILITY NUMBER: 565800551
VISIT DATE: 05/03/2024
NARRATIVE
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On the allegation that Facility staff are retaining a resident requiring a higher level of care, the reporting parties concern is that Resident#1 (R1), needs a higher level of care due to R1 being aggressive, refusing to take medication, walking off property and nothing is being done. To investigate the allegation, the LPA conducted interviews and conducted a file review. Interviews and documents revealed that R1 has a 24hr private caregiver that is not affiliated with the facility. Administrator Matteo stated that R1 did show signs of needing a higher level of care, however they took the steps necessary to assist R1. Administrator Matteo stated that R1's physician and R1's responsible party were notified of R1's behavior and were working collaboratively to provide the care needed. Documents reviewed revealed that staff was in constant communication with R1's physician, addressing R1's behavior. Based on the information gathered, the above allegation is deemed Unsubstantiated at this time.

Exit interview was conducted, and a copy of the report was issued.
SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Esther Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2