197608081-7-27-2023-31-AS-EMIR-CVPTJB-20230915144603

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608081
Report Date: 07/27/2023
Date Signed: 07/27/2023 02:22:31 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
07/25/2023 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20230725162316

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: 133	DATE:	07/27/2023
		UNANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Alberta Cedano, Joyce Martinez		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Resident developed a pressure injury due to neglect by staff
Facility staff are not repositioning resident
Facility staff failed to monitor resident's water and food intake resulting in hospitalization

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 staff, Alberta Cedano and Joyce Matinez. They were advised of the complaint. Today's investigation consisited of a physical plant inspection to insure the health and safety of the residents in care, which was conducted approximately 9:00am-10:00am. Between 10:00am to 11:30am interviews were made with facility staff and Resident 1 (R1). Between 11:30am to 1:00pm, LPA conducted a record review and requested for copies of R1's records.

Resident developed a pressure injury due to neglect by staff/Facility staff are not repositioning resident:
In regards to the allegation, it was reported that the facility was not turning R1 as frequently as they should have, therefore causing a pressure injury. It's unspecified where the pressure injury is located as there was no pictures provided. Also not disclosed were the stages of the wound. Interviews with four (4) of four (4) staff reveal that R1 does not have any pressure injuries greater than a stage II. Interviews with staff

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: 07/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023

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-20230725162316

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: 07/27/2023

NARRATIVE

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also reveals that R1 is repositioned every two hours. Review of R1's records reveal that R1 is receiving hospice care, and only indicates a stage II at the coccyx, being treated by hospice and facility staff. No indication on file that R1 has anything greater than a stage II injury. Also observed during review of R1's records is confirmation that staff has been changing R1's diaper and repositioning R1 every two hours. No indication that the injury has progressed. Moreover, R1's medical assessment and appraisals does not indicate a history of any skin condition or breakdowns. Based on the information obtained, there was insufficient evidence to prove that R1 developed a pressure injury due to staff neglect in not repositioning R1. Therefore, the allegation is deemed Unsubstantiated at this time.

Facility staff failed to monitor resident's water and food intake resulting in hospitalization:
In regards to the allegation, it was reported that R1 was taken to the hospital, on or about 07/12/23 for a high fever and possible UTI. It's alleged that R1 had not been fed enough to keep their weight up, was dehydrated, and had a pressure injury. Interview with four (4) of four (4) staff reveal that R1 was sent to the hospital for weakness and loss of appetite. Copy of the Incident Report was obtained to confirm that R1 was sent to the hospital, despite hospice orders. Staff stated R1 does have a pressure injury, but it was being monitored by hospice and facility staff, R1 was being repositioned, and the injury wasn't greater than a stage II. Also, at admission, R1 weighed 161, but because R1 was experiencing a loss of appetite, R1 was last weighed at 158 lbs. Review of R1's discharge papers did not indicate an admitting diagnosis of a high fever and UTI. R1 was admitted to the hospital for another diagnosis on or around 07/02/23 and discharged with new orders to treat their infection approximately seven days after. LPA was able to interview R1 who did admit there are times that they had no appetite to eat, despite staff's encouragement to have their meals. R1 gave no indication, nor alleged staff failing to monitor their water and food intake causing them to go to the hospital. Based on the information obtained, there was insufficient evidence to prove that facility staff failed to monitor resident's water and food intake resulting in hospitalization . 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: 07/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023

LIC9099 (FAS) - (06/04)

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