191201867-3-19-2025-29-AS-KLOZ-DF3VCY-20250324161955

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191201867
Report Date: 03/19/2025
Date Signed: 03/19/2025 02:36:16 PM

Substantiated

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
03/14/2025 and conducted by Evaluator Trevor Byrne

COMPLAINT CONTROL NUMBER: 29-AS-20250314141748

FACILITY NAME:	EISENBERG VLG OF THE LA JEWISH HOME FOR THE AGING		FACILITY NUMBER:	191201867
ADMINISTRATOR:	GLASS, KATHLEEN K.		FACILITY TYPE:	740
ADDRESS:	18855 VICTORY BOULEVARD		TELEPHONE:	(818) 774-3000
CITY:	RESEDA	STATE: CA	ZIP CODE:	91335
CAPACITY:	271	CENSUS: 80	DATE:	03/19/2025
		UNANNOUNCED	TIME BEGAN:	12:09 PM
MET WITH:	Allison Tepper		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff did not maintain a comfortable temperature for residents.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Trevor Byrne conducted a unannounced complaint investigation visit at the facility at 12:09 PM. LPA met with facility Executive Administrative Assistant Allison Tepper the reason for the visit was explained and entrance interview was conducted.

During today’s visit LPA conducted a physical plant tour, and interviewed the Administrator, five (5) Staff members, and ten (10) residents between 12:25 PM and 02:15 PM.

Continued on LIC-9099C

Substantiated

Estimated Days of Completion: 7

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025

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-20250314141748

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: EISENBERG VLG OF THE LA JEWISH HOME FOR THE AGING	FACILITY NUMBER: 191201867
	VISIT DATE: 03/19/2025

NARRATIVE

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The allegation of “Staff did not maintain a comfortable temperature for residents.” alleges that common rooms in the facility are not maintained at a comfortable temperature for residents. During today’s visit the outside temperature was approximately 72 degrees Fahrenheit. During the physical plant tour LPA observed the Newman Building in which the resident rooms are located. LPA observed the thermostats to be set at a comfortable temperature of 76 degrees Fahrenheit. LPA observed resident rooms to be equipped with their own AC/Heater unit with controls that can be adjusted on a room-to-room basis. Additionally, LPA toured the conference room, the synagogue, lounge rooms, library, dining room, and crafts room. All rooms were observed to be within a range of 68-76 degrees Fahrenheit. All rooms LPA toured at the time of the visit were a comfortable temperature. Interviews with residents revealed that the dining room, library, post office, and beauty salon have all been uncomfortably cold previously. Residents stated that the dining room side doors, when opened, create a strong draft that rapidly cools the room. LPA interviewed staff members who stated that the complaints about the dining room’s temperature come from residents utilizing the side doors to enter/exit the room which creates a draft. Staff stated that residents are instructed to not utilize the side doors and measures including signage, cones, and yellow tape are used to dissuade residents from using the side doors. LPA interviewed the Administrator who stated that they have not received complaints about the temperature of the facility recently. The Administrator was aware of the issues in the dining room regarding the side doors. The Administrator stated that in addition to the previous measures the facility has rearranged the dining room layout to move resident’s tables away from the doors. The Administrator stated that they would instruct maintenance to perform room temperature checks prior to scheduled activity times to ensure rooms are maintained at a comfortable temperature. Additionally, the Administrator agreed to speak with residents who do not follow the facility’s directive to avoid using the side doors of the dining room. Based on the information obtained during interviews there is sufficient evidence to support the allegation of “Staff did not maintain a comfortable temperature for residents.” Therefore, the allegation is deemed Substantiated at this time.

The Administrator was unable to come to the facility at the time of the inspection but has designated Executive Administrative Assistant Allison Tepper to sign this report on their behalf. The following deficiency was cited (refer to LIC 9099D). A copy of the report was printed, appeal rights were provided, and exit interview was conducted.

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20250314141748

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: EISENBERG VLG OF THE LA JEWISH HOME FOR THE AGING	FACILITY NUMBER: 191201867
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/19/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/02/2025 Section Cited CCR 87303(b)	1 2 3 4 5 6 7	87303 Maintenance and Operation (b) A comfortable temperature for residents shall be maintained at all times. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Licensee will submit proof of appropriate room temparatures for common rooms of the facility and their plan on how they will ensure common rooms are maintained at a comfortable temparature. Licensee will submit these documents to CCLD no later than POC due date.
	8 9 10 11 12 13 14	Based on interviews the licensee did not comply with the section cited above as residents have stated that common rooms of the facility are not maintained at a comfortable temparature which poses a potential health and personal rights risk to clients in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISORS NAME: Kasandra Lopez
LICENSING EVALUATOR NAME: Trevor Byrne
LICENSING EVALUATOR SIGNATURE:	DATE: 03/19/2025

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/19/2025

LIC9099 (FAS) - (06/04)

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