191290642-8-24-2023-31-AS-NMAN-CZ6NVS-20240104094826

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191290642
Report Date: 08/24/2023
Date Signed: 08/24/2023 04:22:10 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 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
08/17/2023 and conducted by Evaluator Rosaura Valenzuela

COMPLAINT CONTROL NUMBER: 31-AS-20230817095119

FACILITY NAME:	LEISURE VALE RETIREMENT HOTEL		FACILITY NUMBER:	191290642
ADMINISTRATOR:	CELIA GARCIA		FACILITY TYPE:	740
ADDRESS:	413 E. CYPRESS		TELEPHONE:	(323) 697-2248
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY:	199	CENSUS:	DATE:	08/24/2023
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Celia Garcia, Administrator		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff do not properly safeguard the facility grounds

Staff do not ensure the residents are afforded privacy

Staff allow unauthorized individuals access to the facility

Staff do not provide a comfortable environment for the residents

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an unannounced complaint investigtion visit for the above noted allegations. LPA met with Administrator Celia Garcia. The purpose of the viist was explained.

It was reported that staff do not properly safeguard the facility grounds, since visitors are allowed inside the facility. To investigate this allegation on, 8/24/2023 at 11:09am, LPA conducted a physical plant tour. At 11:45am, LPA requested copies of facility documents relevant to the investigation. Between 12:00pm and 12:30pm, LPA initiated staff interviews. Interviews revealed that Resident #1 (R1) is mentally disturbed and thinks that staff are trying to poison them. Between 12:30pm and 2:00pm, LPA reviewed facility records. Records revealed that R1 is psychologically impaired. In addition, facility house rules state that all visitors must sign in and that visiting hours are from 9:00am to 8:00pm.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Rosaura Valenzuela	TELEPHONE: 818-596-4334
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023

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-20230817095119

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: LEISURE VALE RETIREMENT HOTEL	FACILITY NUMBER: 191290642
	VISIT DATE: 08/24/2023

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

Based on interviews and records review there is not sufficient information to support this allegation. Therefore, this allegation is UNSUBSTANTIATED at this time.

It was alleged that staff do not ensure the residents are afforded privacy, since visitors snoop around the rooms of residents. To investigate this allegation, LPA Valenzuela interviewed staff between 12:00pm and 12:30pm. Interviews revealed that per facility house rules residents sharing a room must meet their visitors in a common area. Residents not sharing a room, can have visitors inside their rooms. If more privacy is needed the residents are told to contact the office. Staff deny that visitors are allowed to loiter in the facility. Records reviewed confirm what staff told LPA.

Based on interviews and records review there is not sufficient information to support this allegation. Thus, this allegation is UNSUBSTANTIATED at this time.

It was alleged that staff allow unauthorized individuals access to the facility. To investigate this allegation, LPA interviewed staff between 12:00pm and 12:30pm. Interviews revealed that all visitors need to sign in and that new residents have recently moved into the community. The community has greatly expanded. R1 does not socialized and mostly stays in their room. R1 is probably not familiar with the new residents and thinks that they are outsiders.

Based on interviews and records review there is not sufficient information to support this allegation. Therefore, this allegation is UNSUBSTANTIATED at this time.

It was reported that staff do not provide a comfortable environment for the residents. To investigate this allegation, LPA conducted a physical plant tour at 11:09am. The facility was observed to be clean with repairs currently being made. Signs are posted throughout the facility letting residents and visitors know that construction is taking place. The repairs do not seem impair residents from going about their activities of daily living. Between 12:00pm and 12:30pm, staff interviews were initiated. Interviews revealed that staff have not received any complaints from residents being upset about the renovations that are being done to the facility. LPA observed staff to be friendly and helpful towards residents.
Based on observation and interviews, there is not sufficient information to support this allegation. Therefore, it is UNSUBSTANTIATED. Exit interviewed conducted and a copy of the report was issued.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Rosaura Valenzuela	TELEPHONE: 818-596-4334
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2