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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565850150
Report Date: 05/02/2024
Date Signed: 05/02/2024 03:03:30 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
04/26/2024 and conducted by Evaluator Kelly Dulek
PUBLIC
COMPLAINT CONTROL NUMBER: 29-AS-20240426130757
FACILITY NAME:VARENITA OF WESTLAKEFACILITY NUMBER:
565850150
ADMINISTRATOR:VEJAR, MERIFACILITY TYPE:
740
ADDRESS:95 DUSENBERG DRIVETELEPHONE:
(805) 413-3300
CITY:WESTLAKESTATE: CAZIP CODE:
91362
CAPACITY:90CENSUS: 90DATE:
05/02/2024
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Brad StewartTIME COMPLETED:
03:05 PM
ALLEGATION(S):
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Staff did not treat resident with dignity and respect
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kelly Dulek arrived at the facility unannounced to conduct an initial complaint visit for the above allegation. LPA arrived at 09:10AM and was initially greeted by front desk staff. LPA was informed that Executive Director (ED) Brad Stewart was unavailable, so LPA met with Wellness Director Mark Brassfield. LPA informed Wellness Director of the purpose of today's visit. Entrance interview conducted.

During today's visit, LPA conducted interviews with staff at 09:25AM, 09:38AM, 09:58AM, and 02:29PM. LPA, along with Wellness Director toured the facility at 10:24AM. LPA also interviewed residents between 10:57AM and 02:03PM and ED at 12:55PM. The following was then determined:

It was alleged that Staff #1 (S1) spoke to Resident #1 (R1) in an inappropriate manner during a conversation. Interview revealed that R1 had purchased over the counter medication for another resident and
Report Continued on LIC 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024
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-20240426130757
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: VARENITA OF WESTLAKE
FACILITY NUMBER: 565850150
VISIT DATE: 05/02/2024
NARRATIVE
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had given the medication to that other resident. When S1 was made aware of R1 having given the medication to Resident #2 (R2), who is on medication management, S1 spoke to R1 related to the facility's policies regarding medications. Other staff present when the conversation occurred indicated that S1 approached R1 while in the facility's salon, but had brought the conversation outside the room for privacy. Staff who witnessed the interaction indicated S1 remained professional when communicating with R1, that S1 was clear in their communication and reiteration of policies. Staff interviewed also indicated R1 was interrupting and speaking to S1 in a rude tone, but that at no time did S1 react negatively. S1 did recall the interaction with R1, but denied the allegation. Interviews with residents throughout the facility revealed that facility staff are kind, courteous and helpful. Neither staff nor residents interviewed had heard of or were aware of any incidents where staff were disrespectful or did not treat residents with dignity. Based on interview, although the allegation may be valid, at this time there is insufficient evidence to support the allegation, therefore the allegation "Staff did not treat resident with dignity and respect" is deemed UNSUBSTANTIATED at this time.

No citations issued. Exit interview conducted. A copy of today's report was provided.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Kelly Dulek
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024
LIC9099 (FAS) - (06/04)
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