<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608081
Report Date: 08/29/2022
Date Signed: 08/29/2022 02:11:08 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
01/26/2021 and conducted by Evaluator Wendell Smith
COMPLAINT CONTROL NUMBER: 31-AS-20210126132048
FACILITY NAME:AVANTGARDE SENIOR LIVING OF TARZANAFACILITY NUMBER:
197608081
ADMINISTRATOR:ERIN MAHONEYFACILITY TYPE:
740
ADDRESS:5645 LINDLEY AVENUETELEPHONE:
(818) 881-0055
CITY:TARZANASTATE: CAZIP CODE:
91356
CAPACITY:138CENSUS: 116DATE:
08/29/2022
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Carol Garcia-TrejoTIME COMPLETED:
02:10 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee is in financial distress
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Wendell Smith conducted an unannounced subsequent visit to finish investigation into the allegation above. LPA met with administrator and explained the reason for this visit.

It is alleged that several employees were not being paid during the period of December 2020 through January 2021. LPA conducted initial visit on 1/27/21 and interviewed Erin Mahoney who was the administrator at that time. During today's visit LPA interviewed the current administrator and facility staff who were working during December 2020 from 10-1pm. LPA also obtained and reviewed documents regarding payroll from the period of December 2020-January 2021 from 1-1:45pm. Interviews with facility staff indicated that staff had were paid and there were no issues with staff being paid. Documents obtained show that employees were paid during December 2020 through Janurary 2021. Based on the information obtained through interviews and documentation this allegation is deemed Unsubstantiated at this time. Exit interview conducted. Copy of report issued.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Wendell SmithTELEPHONE: (818) 738-4525
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 1