197608081-11-1-2022-31-AS-RRAZ-CLL8UW-20221127215013

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608081
Report Date: 11/01/2022
Date Signed: 11/01/2022 02:48:45 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
10/24/2022 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20221024115542

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: 112	DATE:	11/01/2022
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Abigail Gigante, Joyce Martinez, Alberta Cedano		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff do not treat resident with respect
Staff do not follow through with residents medical appointments

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 staff Joyce Martinez and Alberta Cedano, and advised them of the allegations. During the course of the investigation, interviews with staff and residents were made. Records were also reviewed and copies obtained. Between 9:30am to 12:00pm, interviews were made with staff and residents. From 12:00pm to approximately 1:00pm, Resident 1 (R1) records were reviewed.

Staff do not treat residents with respect:
In regards to the allegation, it was reported that some residents are being treated differently than others. LPA conducted interviews with ten of ten residents. There were no complaints or concerns from these residents about being treated different, or better than the other. According to the assistant administrator and staff, they haven't received any complaints either regarding residents being treated differently from one

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: 11/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2022

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-20221024115542

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: 11/01/2022

NARRATIVE

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another. Based on the information obtained through interviews, there was insufficient evidence to corroborate the allegation of staff not treating residents with respect and/or differently. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff do not follow through with residents medical appointments:
In regards to the allegation, it was reported that staff is not helping Resident 1 (R1) with eye appointments. Also staff never followed up with subsequent eye visits so R1 could get glasses. LPA interviewed R1, who confirms the allegation, but according to facility staff, R1 is independent, and able to make their own appointments. Furthermore, staff states that they do assist R1 in making all their medical and dental appointments, but R1 refuses to go to them. Most recently staff confirms that R1 refused to go to their eye appointment on at least a couple occasions. LPA called R1's social worker, and nurse practitioner to confirm staff's statements for R1 refusing to go to their medical appointments. Both the social worker and nurse practitioner confirmed information provided by facility staff. The social worker confirmed that on or about August 2022, R1 refused twice to go to their eye doctor appointment, stating both times transportation arrangements were made, but R1 refused to come down from their room to make the appointment. Staff states that they continue to encourage R1 to make their medical appointment, and follows up. R1 continues to state they do and are independent and can make decisions on their own. R1's primary physician and responsible party/closest relative are aware of R1's behavior and independence. Furthermore, a review of R1's files indicate that R1 is independent and can arrange their own transportation. Based on the information obtained, there was insufficient evidence to corroborate the allegation of staff not following through with the resident's medical appointments. 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: 11/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2022

LIC9099 (FAS) - (06/04)

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