197601283-8-24-2022-31-AS-RRAZ-CK75D9-20221013195135

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197601283
Report Date: 08/24/2022
Date Signed: 08/24/2022 11:55:06 AM

Substantiated

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., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/24/2022 and conducted by Evaluator Jose Gary Tan

COMPLAINT CONTROL NUMBER: 31-AS-20220124115111

FACILITY NAME:	BETTER LIVING AND CARE		FACILITY NUMBER:	197601283
ADMINISTRATOR:	STELLA, EZROS		FACILITY TYPE:	740
ADDRESS:	734 NORTH LA JOLLA AVENUE		TELEPHONE:	(323) 651-2733
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90046
CAPACITY:	6	CENSUS: 3	DATE:	08/24/2022
		UNANNOUNCED	TIME BEGAN:	08:57 AM
MET WITH:	Stella Ezros - Administrator		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Facility did not seek timely medical treatment for resident's injuries

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Gary Tan conducted an unannounced subsequent complaint visit at this facility to deliver the findings for the above allegations. LPA met with Administrator Stella Ezros and explained the reason for the visit.

On 01/24/22, a complaint was received by the Woodland Hills Adult and Senior Care Regional Office. The complaint was referred to and accepted by Community Care Licensing Division’s Investigations Branch (IB) and assigned to IB investigator Tiffany Brunelli.

On 01/25/2022 at 9:02 AM, LPA Tan initiated the complaint visit. LPA Tan interviewed the administrator and staff and obtained copies of the facility records relevant to the investigation.

(continued to LIC 9099-C)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Jose Gary Tan	TELEPHONE: (323) 213-1149
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2022

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 5

Control Number 31-AS-20220124115111

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., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: BETTER LIVING AND CARE	FACILITY NUMBER: 197601283
	VISIT DATE: 08/24/2022

NARRATIVE

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(continued from LIC 9099)

During the course of the investigation, LPA Tan interviewed the administrator and staff on 01/25/2022 between 11:15 AM to 1:00 PM. Investigator Brunelli interviewed the administrator, staff, family member, hospital and fire department and law enforcement staff on different dates and time from 03/14/22 to 07/18/22. IB Investigator Brunelli also reviewed hospital record, Los Angeles Police Department (LAPD) and Los Angeles Fire Department (LAFD)’s record on 05/6/22 and 05/27/22.

Regarding the allegation that the Facility did not seek timely medical treatment for resident's injuries, it was alleged that Resident #1 (R1) was being burned for two (2) hours prior to anyone from the facility calling 911. IB Investigator Brunelli’s interview with staff on 03/24/22 at 2:05 PM and 03/25/22 at 11:15 AM and LPA’s interview with staff on 01/25/22 at around 10:30 AM revealed that the incident occurred between 4:50 PM to 5:10 PM. IB Investigator Brunelli’s record review of the 911 call record on 05/27/22 however, revealed that the first 911 call regarding the incident was at 7:07:31 PM. IB Brunelli’s interview with the administrator on 3/14/22 at 12:11 PM and LPA’s interview on 01/25/22 at around 11:45 PM also revealed that R1 and R1’s family member (FM) refused to be sent to the hospital initially.

Overall investigation concluded that although R1 and their family member refused to send R1 to the hospital, the staff should have immediately call 911 as R1’s injuries has resulted in an imminent threat to resident’s health and safety.

Therefore, based on the information gathered during the course of the investigation, the allegation is deemed substantiated at this time.

Citation issued. Appeal rights discussed and given. Exit interview conducted. Copy of this report issued.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Jose Gary Tan	TELEPHONE: (323) 213-1149
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 31-AS-20220124115111

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., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: BETTER LIVING AND CARE	FACILITY NUMBER: 197601283
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/24/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 08/26/2022 Section Cited CCR 87465(g)	1 2 3 4 5 6 7	The licensee shall immediately telephone 9-1-1 if an injury or other circumstance has resulted in an imminent threat to a resident’s health including, but not limited to, an apparent life-threatening medical crisis except as specified in Sections 87469(c)(2), (c)(3), or (c)(4).	1 2 3 4 5 6 7	Licensee agreed to submit a written statement understanding section 87465(g) of the regulation and to formulate a new policy in the facility to abide by this regulation, to be submitted to CCL on or before the POC date.
	8 9 10 11 12 13 14	This requirement is not as evidenced by: Based on IB Investigator record review and interview, the llicensee did not immediately call 911 after the incident regarding R1 which poses an immediate health risk to the resident 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.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Jose Gary Tan	TELEPHONE: (323) 213-1149
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 5

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., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/24/2022 and conducted by Evaluator Jose Gary Tan

COMPLAINT CONTROL NUMBER: 31-AS-20220124115111

FACILITY NAME:	BETTER LIVING AND CARE		FACILITY NUMBER:	197601283
ADMINISTRATOR:	STELLA, EZROS		FACILITY TYPE:	740
ADDRESS:	734 NORTH LA JOLLA AVENUE		TELEPHONE:	(323) 651-2733
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90046
CAPACITY:	6	CENSUS: 3	DATE:	08/24/2022
		UNANNOUNCED	TIME BEGAN:	08:57 AM
MET WITH:	Stella Ezros - Administrator		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Resident sustained major injuries while in care

Staff did not have adequate knowledge of first aid to properly treat injuries

INVESTIGATION FINDINGS:

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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Jose Gary Tan	TELEPHONE: (323) 213-1149
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 31-AS-20220124115111

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., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: BETTER LIVING AND CARE	FACILITY NUMBER: 197601283
	VISIT DATE: 08/24/2022

NARRATIVE

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(continued from LIC 9099-A)

During the course of the investigation, LPA Tan interviewed the administrator and staff on 01/25/2022 between 11:15 AM to 1:00 PM. Investigator Brunelli interviewed the administrator, staff, family member, hospital and fire department and law enforcement staff on different dates and time from 03/14/22 to 07/18/22. IB Investigator Brunelli also reviewed hospital record, Los Angeles Police Department (LAPD) and Los Angeles Fire Department (LAFD)’s record on 05/6/22 and 05/27/22.

Regarding the allegation that Resident sustained major injuries while in care, it was alleged that R1 sustained significant burns 30% to 40% of R1’s body. IB Investigator Brunelli’s interview with staff on 03/24/22 at 2:05 PM and 03/25/22 at 11:15 AM and LPA’s interview with staff on 01/25/22 at around 10:30 AM revealed that R1 had been living at the facility since 04/12/18 and had a daily routine of smoking after every meal at the same place in the residence, which is just outside by the gated swimming pool. There were two (2) care staff on duty at the time of the incident and they were checking R1 periodically every five (5) to ten (10) minutes. Investigator Brunelli’s interview with FM on 03/14/22 at 12:11 PM also revealed that the FM noticed that it was on the day of the incident and thought of calling the facility to notify the staff about the windy condition as FM was aware that R1 usually smokes outside of the house but was not able to, for some reason. FM also expressed that FM did not suspect any foul play or negligence on the part of the staff.

Regarding the allegation that Staff did not have adequate knowledge of first aid to properly treat injuries, it was alleged that while the staff attempted to treat R1’s injuries it was the incorrect treatment. LPA record review on 01/25/22 revealed that both staff on duty on the night of the incident had a current first aid certificate on file. LPA’s interview also revealed that the staff applied what they learned from their training and do the best that they can to assist R1 given the circumstances.

Based on the information gathered during the course of the investigation, there is insufficient information to support the allegations and therefore deemed unsubstantiated at this time.

Exit interview conducted. Copy of this report issued.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Jose Gary Tan	TELEPHONE: (323) 213-1149
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2022

LIC9099 (FAS) - (06/04)

Page: 5 of 5