197608081-3-25-2022-31-AS-EMIR-CDAM2C-20220408091317

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608081
Report Date: 03/25/2022
Date Signed: 03/25/2022 04:42:04 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
11/01/2021 and conducted by Evaluator Wendell Smith

COMPLAINT CONTROL NUMBER: 31-AS-20211101161122

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: 111	DATE:	03/25/2022
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Caroline Garcia		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Resident was sexually abused while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Wendell Smith conducted an unannounced complaint visit to finish investigation into the allegation above. LPA met with facility staff and explained the reason for this visit. This complaint was referred to accepted by the Investigations Branch (IB). IB Investigator Harmin Sandhu conducted the investigation.
It is alleged that resident #1 (R1) was sexually abused by staff #1 (S1). This investigation consisted of interviews with R1 and facility staff on 12/20/21. R1's physician report was obtained and reviewed. Information obtained from interviews reveal that on 10/28/21 at approximately 11am facility staff went to R1's room, knocked on the door then opened the door and observed S1 partially undressed from the waist down with R1. Facility staff promptly left the room and alerted the administrator. S1 was promptly escorted from the facility. Interviews were conducted with R1 and other facility staff. Information from interviews reveal that S1 and R1 were involved in a consensual sexual relationship. Los Angeles Police Department (LAPD) noted that the relationship was consensual and no incident report from them was filed. Based on the information obtained through interviews this allegation is deemed Unsubstantiated. Exit Interview conducted.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Wendell Smith	TELEPHONE: (818) 738-4525
LICENSING EVALUATOR SIGNATURE:	DATE: 03/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/25/2022

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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