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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608081
Report Date: 03/12/2025
Date Signed: 03/12/2025 03:46:24 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 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
03/07/2025 and conducted by Evaluator Nicholas Reed
COMPLAINT CONTROL NUMBER: 31-AS-20250307142139
FACILITY NAME:AVANTGARDE SENIOR LIVING OF TARZANAFACILITY NUMBER:
197608081
ADMINISTRATOR:CAROLINA GARCIA-TREJOFACILITY TYPE:
740
ADDRESS:5645 LINDLEY AVENUETELEPHONE:
(818) 881-0055
CITY:TARZANASTATE: CAZIP CODE:
91356
CAPACITY:138CENSUS: 125DATE:
03/12/2025
UNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Joyce MartinezTIME COMPLETED:
03:40 PM
ALLEGATION(S):
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Facility staff not following physician's orders
INVESTIGATION FINDINGS:
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At 12:15 p.m. on 03/12/2025 Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with the assistant administrator and disclosed the reason for the visit.

To investigate the allegations above, LPA interviewed staff and Resident #1 (R1) today between 12:20 p.m. and 2:00 p.m., conducted a record review of pertinent records, including but not limited to an admission agreement, medical assessment, care plan, and staff and client rosters at 1:00 p.m., and toured the facility inside and out at 1:15 p.m.

Regarding the allegation "Facility staff not following physician's orders" it was alleged staff did not follow discharge orders from R1’s surgery on 03/06/25. Interview with the assistant administrator at 12:50 p.m. today revealed R1 did not initially provide the discharge paperwork to staff.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
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 2
Control Number 31-AS-20250307142139
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.ASC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: AVANTGARDE SENIOR LIVING OF TARZANA
FACILITY NUMBER: 197608081
VISIT DATE: 03/12/2025
NARRATIVE
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R1 receives minimal assistance and can perform most aspects of daily living on their own. Record review of R1’s admission agreement and preadmission appraisal revealed R1 is self-responsible and does not require assistance with bathing, dressing, grooming, or eating. R1 also manages their own medications. R1’s medical assessment indicated that they had no cognitive impairment and are able to communicate their needs. Record review of R1’s discharge instructions revealed R1 was to rest, wear an arm sling, exercise, wait to bathe to allow stitches to heal, continue all regular medications, and take their temperature once daily to check for a fever. Interview with R1 at 1:30 p.m. today revealed facility staff did not check their temperature until today. R1 stated they tried to use the mounted thermometer in the lobby but were unsuccessful. Interview with Staff #1 (S1) at 2:00 p.m. today revealed care staff were aware of R1’s discharge orders. S1 was told by R1 that they did not need any assistance with following the discharge orders. Based on observations, interviews, and record review, R1 was capable of following all discharge orders on their own and able to communicate to staff when they needed assistance with taking their temperature. R1 did not report any need for assistance. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Exit interview conducted. Copy of report provided.
SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Nicholas Reed
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2