197608081-10-3-2023-31-AS-NMAN-CXEU6Q-20231109141843

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608081
Report Date: 10/03/2023
Date Signed: 10/03/2023 03:01:02 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
06/22/2023 and conducted by Evaluator Tihesha Smith

COMPLAINT CONTROL NUMBER: 31-AS-20230622091845

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: 129	DATE:	10/03/2023
		UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Carolina G Trejo		TIME COMPLETED:	03:12 PM

ALLEGATION(S):

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Personnel qualifications

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tihesha Smith made an unannounced complaint visit to this facility at pm to deliver findings. LPA Smith met with facility staff and disclosed the purpose of this visit. The administrator was contacted and arrived later.
During initial visit, on 06/26/23, LPA Smith conducted tour of physical plant and conducted interviews from approximately 10:15 am -12:50 pm.
Personnel qualifications

It was alleged that the Administrator conducted themself in an unprofessional manner. During initial visit LPA Smith conducted interview with administrator. LPA was unable to interview Reporting Party (RP) as RP was unreachable via contact information provided. During this visit LPA interviewed 5 (five) residents and six (6) staff from 1:10 pm- 2:20 pm. Interview with administrator revealed that always conducts self in professional manner and treats everyone with respect whether in person, over phone or via email.
(Cont to 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Tihesha Smith	TELEPHONE: 818-307-6280
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

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-20230622091845

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: 10/03/2023

NARRATIVE

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(Cont from 9099)

Also revealed hired as administrator only works in that capacity. Records review reveal current administrator license on file. Administrator had current trainings on file to include but not limited to Dementia and memory care. Interview with five (5) residents reveal administrator to be pleasant, informative, professional, and helpful. Interview with eight (8) staff reveal administrator to be knowledgeable, helpful, and professional at all times. Staff # 2 (S2) shares office with administrator and revealed that the administrator is always respectful, kind and professional.

Based on interviews and record review during this and previous licensing visits there is insufficient pertinent information to support the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Tihesha Smith	TELEPHONE: 818-307-6280
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

LIC9099 (FAS) - (06/04)

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