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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565802444
Report Date: 11/06/2024
Date Signed: 11/08/2024 03:40:41 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. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/20/2024 and conducted by Evaluator Zabel Chochian
COMPLAINT CONTROL NUMBER: 29-AS-20240620141647
FACILITY NAME:LAND OF ENCHANTMENT 1 BOARD AND CARE LLCFACILITY NUMBER:
565802444
ADMINISTRATOR:ROXANA LARAFACILITY TYPE:
740
ADDRESS:78 W GAINSBOROUGH RDTELEPHONE:
(805) 601-5202
CITY:THOUSAND OAKSSTATE: CAZIP CODE:
91360
CAPACITY:6CENSUS: 6DATE:
11/06/2024
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Roxana LaraTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Facility staff are not following doctor's orders in regards to the resident's use of compression socks.
Facility staff are not following doctor's orders in regards to the resident needing to be out of bed during the day.
Family member was not allowed access to resident records
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Zabel Chochian conducted an initial complaint visit regarding the above noted allegations. LPA met with administrator and the reason for the visit was explained.

On 06/20/20224, Community Care Licensing Division (CCLD) received a complaint with the above allegations. Investigation was initiated by LPA Teresa Camara on 06/26/2024. LPA Camara conducted an initial complaint investigation visit regarding the above noted allegations. LPA initially met with staff who called the administrator. The administrator arrived at 9:50 a.m. and LPA explained the reason for the visit. LPA conducted a brief tour inside the facility at 9:46 a.m. with staff. LPA conducted an interview with administrator starting at 9:50 a.m. LPA reviewed and obtained pertinent records starting at 10:15 a.m.

On 08/07/2024, LPA Chochian conducted additional interviews with staff, residents and reviewed records pertinent to this case between 11:32am-2:15pm.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024
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 3
Control Number 29-AS-20240620141647
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. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: LAND OF ENCHANTMENT 1 BOARD AND CARE LLC
FACILITY NUMBER: 565802444
VISIT DATE: 11/06/2024
NARRATIVE
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Following is a summary of the investigation findings:

Regarding allegation, “Facility staff are not following doctor's orders in regard to the resident's use of compression socks” – It was alleged that staff refuse to put resident #1’s “compression socks”. Interview with facility administrator and staff revealed that R1’s compression socks were used daily throughout the day and when R1’s family would visit they would take them off. Records reviewed revealed that the order for the compression socks was for anytime resident is out of bed. Administrator and staff stated that R1 would have the compression socks on anytime R1 was out of bed and during outings. Staff and administrator expressed that the compression socks were tight so eventually it caused skin tear to R1’s legs. Administrator stated that she contacted the doctor however never received a response back. According to administrator and staff when R1’s legs were elevated they would not put the compression socks because it was causing skin redness and tear. Based on the above information gathered although the allegation may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the above allegation “Facility staff are not following doctor's orders in regard to the resident's use of compression socks” is deemed UNSUBSTANTIATED at this time.

Regarding allegation, “Facility staff are not following doctor's orders in regard to the resident needing to be out of bed during the day” – Information was provided that R1 is to be in the living room, in recliner during the day as ordered by the physician. Staff and administrator stated that R1 was responsive and would request to stay in be and not be transferred with the hoyer lift. However, R1’s family obtained an order for R1 to be out of bed during the day. Administrator stated that R1 was transferred to the dining table for each meal every day; R1 was out of bed for meals; and in the recliner in the living room watching television. Interview with staff and administrator revealed that R1 was out of bed during the day as ordered by the doctor and would only be in the room if resident requested not to be transferred. Based on the above information gathered although the allegations may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the above allegation “Facility staff did not note changes in resident's medical condition” is deemed UNSUBSTANTIATED at this time.

Regarding allegation, “Family member was not allowed access to resident records” – Information was provided that Administrator did not allow family member access to R1’s records when requested (date unknown). Interview with administrator and staff revealed that R1’s family was allowed access to R1’s records. (Continue to LIC 9099c)
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 29-AS-20240620141647
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. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: LAND OF ENCHANTMENT 1 BOARD AND CARE LLC
FACILITY NUMBER: 565802444
VISIT DATE: 11/06/2024
NARRATIVE
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Administrator stated that the family of R1 was at the facility on a weekend and requested records however administrator was not at the facility and therefore could not provide the records. Administrator stated that she informed the family that they may review the records on Monday. Administrator confirmed that the family was provided the records within one day. Based on the above information gathered although the allegations may be valid, there is insufficient evidence to support the allegation or that a violation occurred; therefore, the above allegation “Family member was not allowed access to resident records” is deemed UNSUBSTANTIATED at this time.

Exit interview held. Copy of report provided.
SUPERVISORS NAME: Desaree Perera
LICENSING EVALUATOR NAME: Zabel Chochian
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3