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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 197608044
Report Date: 07/13/2021
Date Signed: 08/04/2021 08:35:07 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME:VISTA VERANDA ASSISTED LIVINGFACILITY NUMBER:
197608044
ADMINISTRATOR:YVETTE LEMFACILITY TYPE:
740
ADDRESS:3540 MARTIN LUTHER KING, JR.TELEPHONE:
(310) 638-4113
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY:178CENSUS: 90DATE:
07/13/2021
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Yvette LemTIME COMPLETED:
09:30 AM
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On 07/13//2021 at 9:00am Regional Manager (RM) Benita Yates, Licensing Program Manager (LPM) Janae Hammond and Licensing Program Analyst (LPA) Ulysses Coronel conducted an office meeting with Licensee Representatives Dr, Jasvant Modi, Kinal Modi, Bhavin Modi, Nishith Modit and administrator Yvette Lem. To follow-up on new administrator expectations discussed during the conference call conducted on 06/17/2021.
The following items were discussed:
  • Administrators did not have access to:

    • 1. administrators office
    2. business office
    3. file room
    4. resident financial records
    5. staff records
    6. PPE supplies/inventory
    7. Indeed.com account / job advertisements.
  • Communication Issues

    • 1. Administrator to create a Facility Repair Form
    2. Administrator to communicate issues directly to CEO Kinal Modi. (per Dr. Modi).
  • Caregiver Staffing Shortage

    • 1. A total of 5 caregivers have left Vista Veranda since June 2021.
    2. A total of 2 caregivers are on vacation for the month of July 2021. (July 1-16 and July 19-31).
  • Per Dr, Modi: Former employees have file law suits against the facility and facility is operating at a loss.
Follow-up items due 07/27/2021:
  1. Administrator Office for Yvete Lem
  2. PPE Inventory
  3. Staffing Updates.
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ulysses CoronelTELEPHONE: (951) 212-8917
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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