197608081-9-28-2021-31-AS-EMIR-C9JR84-20211209114717

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608081
Report Date: 09/28/2021
Date Signed: 09/28/2021 01:13:58 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., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/15/2021 and conducted by Evaluator Calvin Tsui

COMPLAINT CONTROL NUMBER: 31-AS-20210915103232

FACILITY NAME:	AVANTGARDE SENIOR LIVING OF TARZANA		FACILITY NUMBER:	197608081
ADMINISTRATOR:	ERIN MAHONEY		FACILITY TYPE:	740
ADDRESS:	5645 LINDLEY AVENUE		TELEPHONE:	(818) 881-0055
CITY:	TARZANA	STATE: CA	ZIP CODE:	91356
CAPACITY:	138	CENSUS: 103	DATE:	09/28/2021
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Jero Argota		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff do not ensure the residents are properly fed while in care

Residents personal belongings are mishandled while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Calvin Tsui and Alex Pritz conducted a unannounced complaint visit to invesitgate the allegations of "Staff do not ensure the residents are properly fed while in care" and "Residents personal belongings are mishandled while in care".

For the allegation. "Staff do not ensure the residents are properly fed while in care" the allegation indicates the food is in poor quality and the portions are too small, the meals are served at inconsistant times resulting in residents going hungry. At 11:30 a.m. LPA's interviewed 10% of facility census; 5/5 residents interviewed in memory care and 8/8 interviewed in assisted living stated that they where getting enought to eat. Furthermore, LPA observed residents asking for seconds during lunch and getting more. The allegation is unsubstantiated.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Calvin Tsui	TELEPHONE: (818) 216-9775
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021

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 31-AS-20210915103232

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: AVANTGARDE SENIOR LIVING OF TARZANA	FACILITY NUMBER: 197608081
	VISIT DATE: 09/28/2021

NARRATIVE

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Licensing Program Analyst (LPA) Calvin Tsui and Alex Pritz conducted a unannounced complaint visit to invesitgate the allegations of "Staff do not ensure the residents are properly fed while in care" and "Residents personal belongings are mishandled while in care".

For the allegation, "Residents personal belongings are mishandled while in care." The allegation is that resident items are lost in laundry. At 11:30 a.m. LPA's interviewed 10% of facility census; 5/5 residents interviewed in memory care and 8/8 interviewed in assisted living stated that they have not lost items in laundry. This allegation is unsubstantiated.

report reviewed signed and delivered.

exit interview conducted, no deficiency cited.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Calvin Tsui	TELEPHONE: (818) 216-9775
LICENSING EVALUATOR SIGNATURE:	DATE: 09/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2021

LIC9099 (FAS) - (06/04)

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