197608081-8-24-2022-31-AS-EMIR-CHZUQF-20220906154700

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608081
Report Date: 08/24/2022
Date Signed: 08/24/2022 02:38:33 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
08/19/2022 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20220819162959

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: 116	DATE:	08/24/2022
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Carol Garcia-Trejo, Joyce Martinez		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff did not safeguard resident's confidential information.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Michael Cava conducted a complaint visit to the facility to investigate the above allegation. LPA met with the administrator, Carol Trejo and staff, Joyce Martinez, and advised them of the allegation. It was reported that a friend of facility administrator obtained access to Resident 1 (R1's) confidential information due to facility's failure to safeguard R1's information. During the course of the investigation, interviews and record reveiw were made.

According to the administrator and staff, they had no idea that the administrator's friend is in contact with R1. They stated the administrator's friend and R1 only met once, when R1 went out to get a haircut. Both administrator and staff does not know that R1 had multiple interactions with the administrator's friend since they've met. They only know R1 to be low key. In addition, R1 doesn't interact with the other residents in care.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2022

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-20220819162959

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: 08/24/2022

NARRATIVE

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LPA interviewed R1, who confirmed that they've given access to their personal information to the administrator's friend, via mail and telephone calls willingly. R1 stated they receive assistance through the friend normally, and is in contact with the friend every day. In addition, R1 stated that the friend was given access to retrieve R1's mail at R1's home, allowed entrance to enter R1's home to obtain voice messages, and make bank deposits for R1.

Based on the information obtained, there was insufficient evidence to prove that staff did not safeguard resident's confidential information. Therefore, the allegation is deemed Unsubstantiated at this time.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2022

LIC9099 (FAS) - (06/04)

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