191802082-5-7-2025-31-AS-NMAN-DGNUJ6-20250514153701

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191802082
Report Date: 05/07/2025
Date Signed: 05/07/2025 02:44:08 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
12/20/2024 and conducted by Evaluator Antonia Alvizar-Ettima

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20241220142604

FACILITY NAME:	SOLHEIM SENIOR COMMUNITY		FACILITY NUMBER:	191802082
ADMINISTRATOR:	MEG PIERCE		FACILITY TYPE:	741
ADDRESS:	2236 MERTON AVENUE		TELEPHONE:	(323) 257-7518
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90041
CAPACITY:	126	CENSUS: 86	DATE:	05/07/2025
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Marie Garnett, Director of Nursing & Mike Gonzalez, Director Residential Health & Wellness		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff do not maintain adequate records
Lack of staff qualifications lead to residents health complications

INVESTIGATION FINDINGS:

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

At 9:45a.m., Licensing Program Analyst (LPA) Antonia Alvizar- Ettima conducted an unannounced subsequent visit to conduct investigation and deliver the finding for the above noted allegations. LPA met with the Director of Nursing, Director Residential Health & Wellness and explained the reason for the visit.

During initial visit, on 12/20/24 at 11:00a.m., LPA Alvizar-Ettima requested and received a copy of staff and residents’ roster. At approximately 11:20a.m., LPA conducted a tour of the facility, made observations and interviewed facility staff. Between 1:20p.m.- 2:50p.m. LPA interviewed nine (09) out of eight-six (86) residents in Assistant Living and Memory Care. During today’s visit at 11:25a.m., LPA Alvizar-Ettima reviewed six (06) randomly selected resident and seven (07) staff facility files. Between 1:05p.m. – 1:40p.m. interviewed three (03) CNA’s, one (01) caregiver, Resident Service Coordinator and Human Resources Director, asking questions relevant to the complaint.

1.) Staff do not maintain adequate records.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima	TELEPHONE: (818) 383-6108
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2025

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 2

Control Number 31-AS-20241220142604

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: SOLHEIM SENIOR COMMUNITY	FACILITY NUMBER: 191802082
	VISIT DATE: 05/07/2025

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

It was alleged that staff loses facility records. Staff denied losing facility records for residents and staff. Staff indicated that all documents are always maintain in resident’s facility file and staff records are maintained separate. During interviews with nine (09) out of eighty-six (86) residents revealed that they have no issues with their records. When residents request their records staff provides copies of the documents to them. Residents’ interviews confirm that facility maintain adequate records. A review of facility resident records conducted on 05/07/25 supported the information provided by the staff and residents. Records contain their emergency Identification form with contact Information, Admission Agreement, Physician Report, Pre-Appraisal, Property Inventory/Belongings, Medication Administration Records and other miscellaneous records.

Based on observation, interviews and documents review there is an insufficient information to support the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

2.) Lack of staff qualifications lead to residents’ health complications.

It was alleged that due to unqualified staff residents developed pressure injuries. Staff interviews revealed that most caregivers are Certified Nurse Assistant (CNA’s). They have required qualifications to identify pressure injuries and report as required. Other staff confirmed that they received training regarding pressure injuries prevention and assistance. Interview with nine (09) out of eight-six (86) residents reveal that they did not have any pressure injuries. Staff revealed that at this time they have no residents with pressure injuries. A review of facility staff records, including staff training documents and an internal log identifying the frequency of staff assistance for the residents confirmed that staff received adequate training and residents are being assisted and supervised as required.

Based on inspection, observation, interviews and records review, there is no sufficient information to support this allegation. Therefore, this allegation is UNSUBSTANTIATED at this time.

There were no deficiencies cited. Exit interview conducted. Copy of this report issued.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima	TELEPHONE: (818) 383-6108
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 2