197603977-6-30-2021-29-AS-JAPL-C53UNG-20210719154351

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197603977
Report Date: 06/30/2021
Date Signed: 06/30/2021 12:42:03 PM

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
12/07/2020 and conducted by Evaluator Ashley Smith

COMPLAINT CONTROL NUMBER: 29-AS-20201207123537

FACILITY NAME:	EDEN GARDEN "C", INC.		FACILITY NUMBER:	197603977
ADMINISTRATOR:	YADIDI, ROHANGIZ		FACILITY TYPE:	740
ADDRESS:	23601 CANZONET ST.		TELEPHONE:	(818) 348-2308
CITY:	WOODLAND HILLS	STATE: CA	ZIP CODE:	91367
CAPACITY:	6	CENSUS: 6	DATE:	06/30/2021
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Rohangiz Yadidi		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Staff are denying residents access within the facility
Staff threatened a resident while in care
Residents are not afforded privacy while in care
Facility has inadequate record keeping for residents
Staff failed to ensure residents are properly fed while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ashley Smith arrived unannounced at 9:00 a.m. to conduct a subsequent complaint visit to investigate the above allegations. The LPA met with staff and explained the reason for the visit. Administrator Rose Yadidi arrived at approximately 9:20 a.m.

During a visit conducted on 12/17/2020, LPA Aja Richardson spoke with the Administrator at 12 p.m.. During today’s visit, the LPA conducted a tour, observed the kitchen area at 9:20 a.m., reviewed files at 9:25 a.m., interviewed staff at 9:56 a.m. and 10:25 a.m., and interviewed six residents from 10:00 a.m. – 10:20 a.m.

Regarding the allegation: Staff are denying residents access within the facility
It was alleged that staff are restricting access in the common areas by shutting off lights in the early evening, and encouraging residents to be in their bed. Resident interviews confirmed that residents were free to occupy common spaces throughout the day, including in the evening and after hours.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Ashley Smith	TELEPHONE: (818) 421-9032
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2021

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

LIC9099 (FAS) - (06/04)

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Control Number 29-AS-20201207123537

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: EDEN GARDEN "C", INC.	FACILITY NUMBER: 197603977
	VISIT DATE: 06/30/2021

NARRATIVE

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Residents declined the claim that staff encouraged them to stay in their rooms at night, and residents denied hearing staff encourage other residents to do so. Staff interviews claimed that residents were able to occupy common spaces as they pleased and were not restricted to their rooms in the evening. Based on the information obtained, there is insufficient evidence to support the claim that staff are denying residents access within the facility. This allegation is deemed Unsubstantiated at this time.

Regarding the allegation: Staff threatened a resident while in care
It was alleged that staff threatened a resident. Resident interviews claimed that staff treated the residents with respect and declined the claim that staff were observed yelling or threatening any of the residents. Residents claimed that they were treated well, felt safe in the home, and claimed that the staff had appropriate interactions with all the residents in this facility. Staff interviews denied claims that they observed other staff treating or speaking to residents in an unprofessional manner. Based on the information obtained, there is insufficient evidence to support the claim that staff threatened a resident while in care. This allegation is deemed Unsubstantiated at this time.

Regarding the allegation: Residents are not afforded privacy while in care
It was alleged that the bathroom doors did not have locks, which raised privacy concerns. The LPA observed the bathrooms and identified that there were locks on the bathroom doors. Staff and resident interviews supported the claim that the privacy of all residents was respected, and staff were courteous when entering their private rooms. Staff supported the claim that residents were able to lock their doors as desired. Based on the information obtained, there is insufficient evidence to support the claim that residents are not afforded privacy while in care. This allegation is deemed Unsubstantiated at this time.

Regarding the allegation: Facility has inadequate record keeping for residents
It was alleged that the facility failed to have appropriate documentation on file, such as a policy around visitation, house rules, inventory of possessions, and so on. The LPA reviewed resident files at 9:25 a.m. and observed the appropriate documentation. The facility has a separate protocol around visitation and house rules and were observed as an addendum to the file. The LPA also observed and reviewed the facility’s Mitigation Plan as it pertains to COVID-19 and other epidemic outbreaks, which is a required document from the Department. Based on the information obtained, there is insufficient evidence to support the claim that the facility has inadequate record keeping for residents. This allegation is deemed Unsubstantiated at this time.

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Ashley Smith	TELEPHONE: (818) 421-9032
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 29-AS-20201207123537

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: EDEN GARDEN "C", INC.	FACILITY NUMBER: 197603977
	VISIT DATE: 06/30/2021

NARRATIVE

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Regarding the allegation: Staff failed to ensure residents are properly fed while in care
It was alleged that food served at the facility was of poor quality and inappropriate temperatures. Upon entry into the facility, the LPA observed staff cooking breakfast for the residents, which was of sufficient quality and temperatures appeared appropriate. The LPA reviewed the supply of perishable and nonperishable food and found it to be adequate and of substantial variety. The LPA observed a variety of meats, fruits, vegetables, grains, and liquids. Interviews revealed that if a resident does not like a meal, they are offered a different option. Residents did not communicate concerns regarding meal options nor temperatures. During today's visit, the LPA observed that all special diets were being upheld, and the food offered during breakfast and lunch times were hot. It appeared that the facility had a variety of both hot and cold meal options. Based on the information obtained, there is insufficient evidence to support the claim that the staff failed to ensure that residents are properly fed. This allegation is deemed Unsubstantiated at this time.

No deficiencies cited at this time. Citations issued on a separate case management report for deficiencies observed during today’s visit. Exit interview conducted. A copy of the report was provided.

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Ashley Smith	TELEPHONE: (818) 421-9032
LICENSING EVALUATOR SIGNATURE:	DATE: 06/30/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/30/2021

LIC9099 (FAS) - (06/04)

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