197608081-10-13-2022-31-AS-EMIR-CKTRSF-20221103131638

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608081
Report Date: 10/13/2022
Date Signed: 10/13/2022 02:46:01 PM

Unsubstantiated

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
10/10/2022 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20221010101800

FACILITY NAME:	AVANTGARDE SENIOR LIVING OF TARZANA		FACILITY NUMBER:	197608081
ADMINISTRATOR:	CAROLINA GARCIA-TREJO		FACILITY TYPE:	740
ADDRESS:	5645 LINDLEY AVENUE		TELEPHONE:	(818) 881-0055
CITY:	TARZANA	STATE: CA	ZIP CODE:	91356
CAPACITY:	138	CENSUS: 118	DATE:	10/13/2022
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Abigail Gigante-Asst. Admin.		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff do not answer the authorized representatives questions regarding the resident
Staff are not providing the authorized representative with updated requested medication lists
Staff do not ensure the Dr. orders for new medications have been received

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) MIchael Cava conducted a complaint visit to the facility to investigate the above allegations. LPA met with the assistant administrator, Abigail Gigante and advised her of the visit. At approximately 9:45am to 11:30am, interviews with Abigail, front desk staff and two med techs were made. An attempt was also made to interview Resident 1 (R1), but due to their diagnosis, R1 is not responsive to the LPA's questions. From 11:30am to 1:00pm, LPA conducted a review of R1's files and obtained some copies for record. From 1:00pm to 2:00pm, a physical plant inspection of the common areas was made.

Staff do not answer the authorized representative questions regarding the resident:
In regards to the allegation, it was reported that when R1's family would call the facility to ask what the resident's current condition is, staff will tell them that, that is not their job to report this and won't give the family information on R1. Interviews with the administrator, front desk staff and both med tech staff deny the allegation. According to front desk staff, they would either transfer the family's call to memory care

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2022

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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Control Number 31-AS-20221010101800

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: 10/13/2022

NARRATIVE

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or page someone from memory care that there is a call waiting. If no response, the front desk staff would take the call and try to assist the caller as much as they can, or advise them that call will be made back shortly. Interviews with two med techs from memory care also deny the allegation. Both med techs stated that R1's family call at least once a week. Both med techs stated that they would either take the call immediately, or if busy would call the family back immediately and provide the family the the information they requested for. Both med techs have never gotten any complaints that they never returned any calls to R1's family, or to other resident families for that matter. Based on the information obtained, there was insufficient evidence to corroborate the allegation of staff not answering calls/questions from a resident's authorized representative. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff are not providing the authorized representative with updated requested medication lists:
In regards to the allegation, it was reported that when R1 goes to their doctor appointments, they will ask the facility staff to send them an updated medication list. The list the family receive are not updated, wrong or missing medications. Interview with the assistant administrator and both med techs deny the allegation. The assistant administrator and both med techs state they provide R1's family with their request for R1's medication list. Within the last three months, R1 has only received one new order on September 30, 2022, for Seroquel, for an increase in dosage. Prior to that, the last time R1's doctor issued new orders was on June 13, 2022, for a restart and medication adjustment. LPA obtained copies of both orders. Med tech and assistant administrator stated this information was provided to R1's family per their request. If anything new were to come in, they would forward that information to the family as well. Based on the information obtained, there was insufficient evidence to corroborate the allegation of staff not providing the resident's authorized representative an updated medication list. Therefore, the allegation is deemed Unsubstantiated at this time..

Staff do not ensure the Dr. orders for new medications have been received:
In regards to the allegation, it was reported that R1's doctor changed R1's prescription for Seroquel. The family will call the facility to tell them the doctor's office will be faxing in the new order for Seroquel, but staff states they never received it. According to both med techs, the latest order for Seroquel, which is prescribed to increase the dosage was received on September 30, 2022. A copy of this order was obtained. Doctor's office called to confirm. No new orders given since then. Based on the information obtained, the allegation of staff not not insuring order for new medication not being received is Unsubstantiated at this time.

SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:	DATE: 10/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2022

LIC9099 (FAS) - (06/04)

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