197604445-2-1-2024-31-AS-NMAN-D54MFJ-20240509093426

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197604445
Report Date: 02/01/2024
Date Signed: 02/01/2024 01:38:07 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.ASC, 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
08/16/2023 and conducted by Evaluator Nicholas Reed

COMPLAINT CONTROL NUMBER: 31-AS-20230816104132

FACILITY NAME:	RAYA'S PARADISE, INC.		FACILITY NUMBER:	197604445
ADMINISTRATOR:	MOTI GAMBURD		FACILITY TYPE:	740
ADDRESS:	1156 N. GARDNER ST.		TELEPHONE:	(323) 815-8858
CITY:	WEST HOLLYWOOD	STATE: CA	ZIP CODE:	90046
CAPACITY:	11	CENSUS: 7	DATE:	02/01/2024
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Brian Rosales		TIME COMPLETED:	01:40 PM

ALLEGATION(S):

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Staff do not treat residents with dignity or respect
Staff speak inappropriately to residents
Staff did not seek timely medical attention for a resident
Staff handled resident roughly

INVESTIGATION FINDINGS:

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At 12:30 p.m. on 02/01/2024, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with Administrator and disclosed the reason for the visit.

To investigate the allegations above, LPA conducted an initial visit on 08/24/2023 and toured the facility at 11:50 a.m. and reviewed records at 1:00 p.m. including but not limited to admission agreements, physician’s reports, care plans, and care notes. LPA conducted a subsequent visit on 11/16/2023 and interviewed a family member (F1) at 11:45 a.m., Staff #1 (S1) at 12:30 p.m., Staff #2 (S2) at 12:50 p.m., Staff #3 (S3) at 1:00 p.m., Staff #4 (S4) at 2:30 p.m., Staff #5 (S5) at 2:45 p.m., and Staff #6 (S6) at 3:00 p.m., and five (05) out of eight (08) residents between 1:30 p.m. and 2:30 p.m., and toured the facility at 2:30 p.m.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas Reed	TELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2024

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 31-AS-20230816104132

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: RAYA'S PARADISE, INC.	FACILITY NUMBER: 197604445
	VISIT DATE: 02/01/2024

NARRATIVE

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Regarding the allegation “Staff do not treat residents with dignity or respect” it was alleged staff mistreat residents based on their financial status or race. Interviews with the seven (07) out of seven (07) staff revealed no staff have mistreated residents based on their status. Interviews with five (05) out of five (05) residents interviewed revealed they felt respected by staff and had no concerns about staff disrespect. LPA did not observe any mistreatment of residents during today’s visit or the two previous visits. Based on interviews and observations, facility staff treat residents with respect. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Regarding the allegation “Staff speak inappropriately to residents” it was alleged Staff #7 (S7) used derogatory language towards residents. S7 was unavailable for interview. Interviews with the staff and residents revealed they had never heard S7 or any other staff using derogatory language. S4 described S7 as a “calm and level” individual. The facility terminated S7 due to attendance issues. Based on interviews, staff do not speak inappropriately to residents. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Regarding the allegation “Staff did not seek timely medical attention for a resident” it was alleged staff ignored an open sore on the nose of Resident #1 (R1) and do not attempt to treat it. Interview with F1 revealed R1’s nose sore had been an ongoing issue for several months. The facility scheduled several appointments to address the sore. Interview with S1 revealed the sore was first noticed in July 2023 by a physician. The facility scheduled a biopsy in September 2023. Staff have treated the sore with ointment and bandaids, but R1 often picks off the bandaid and picks at the sore. Due to the insurance authorization process taking longer than expected, R1's treatment also has taken longer than expected. Record review of R1’s care plan noted they receive ointment twice daily for the sore. Medical notes revealed R1 had an initial physician’s appointment on 07/05/2023 and was offered a referral to a dermatologist. R1 refused the referral. A biopsy was performed on 09/11/2023 and a follow-up appointment was attended on 09/13/2023. Appointment notes confirmed the facility is treating R1’s lesion with Mupirocin ointment. S3, S4, and S6 confirmed that it has been an ongoing issue treated by ointment and bandaids as well as medical appointments. Interview with R1 revealed it does not hurt, though the bandaid does get itchy, so they take it off occasionally. R1 was observed on 11/16/2023 wearing a bandaid on their nose. LPA conducted a follow-up interview with S1 at 3:30 p.m. on 01/30/2024 who confirmed the facility has worked with F1 to fully heal R1’s sore, and the sore is almost healed. Based on interviews and record review, the facility sought timely medical attention for R1’s sore. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas Reed	TELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 31-AS-20230816104132

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: RAYA'S PARADISE, INC.	FACILITY NUMBER: 197604445
	VISIT DATE: 02/01/2024

NARRATIVE

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Regarding the allegation “Staff handled resident roughly” it was alleged S2 yanks down Resident #2 (R2) to transfer them to their wheelchair. Interview with S2 revealed they worked in the facility only temporarily, but they never yanked or mishandled any residents. S2 used the assistance of another staff to transfer R2 for safety which was the protocol. Interviews with staff revealed they had never seen S2 or any other staff handle R2 or other residents in a rough manner. Interview with R2 at 2:20 p.m. on 11/16/2023 revealed they felt respected by staff and have never been treated roughly. R2 further stated they enjoyed living at the facility. R2 did not iterate further on how they are transferred from their wheelchair. At approximately 2:30 p.m. on 11/16/2023 LPA observed two staff assisting R2 in transferring from their wheelchair. Based on interviews and observations, facility staff do not handle residents roughly. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

No immediate health and safety hazards were observed during this visit.

Exit interview conducted. Appeal rights discussed. Copy of report provided.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas Reed	TELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2024

LIC9099 (FAS) - (06/04)

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