197608081-12-27-2023-31-AS-NMAN-D8KVY7-20240828165041

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608081
Report Date: 12/27/2023
Date Signed: 12/27/2023 04:50:19 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
12/21/2023 and conducted by Evaluator Nicholas Reed

COMPLAINT CONTROL NUMBER: 31-AS-20231221162813

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: 134	DATE:	12/27/2023
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Carolina Garcia-Trejo		TIME COMPLETED:	04:50 PM

ALLEGATION(S):

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Staff stole residents’ personal belongings.

INVESTIGATION FINDINGS:

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At 12:30 p.m. on 12/27/2023, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced complaint visit. LPA met with the Executive Director (ED) and disclosed the reason for the visit.

Regarding the allegation “Staff stole residents’ personal belongings” it was alleged staff stole cash and perfume from Resident #1 (R1). To investigate the allegation, LPA interviewed six (06) staff between 12:30 p.m. and 1:30 p.m., fourteen (14) out of one hundred thirty (134) residents which was 10% of residents between 1:30 p.m. and 3:00 p.m., reviewed records including but not limited to a staff list, resident list, physician’s report, inventory list, admission agreement, and identification form at 3:00 p.m., and toured the facility at 1:30 p.m. Interviews with staff revealed the missing items were reported to the ED. The ED provided R1 two (02) lockboxes to R1 and offered to reimburse R1 for the missing items. The ED suggested R1 complete an inventory form to document their possessions. No caregivers or maintenance staff with access to rooms knew of any thefts or lost items.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas Reed	TELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:	DATE: 12/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/27/2023

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-20231221162813

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: 12/27/2023

NARRATIVE

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Interview with residents revealed R1 did not want to fill out an inventory sheet or use the lockboxes provided by the facility. Resident #2 (R2) believed cash was stolen from them while they were sleeping about 5 months ago, and Resident #3 (R3) believed they had perfume taken from them within the past month. R2 and R3 believed staff or residents took the items. Neither R2 nor R3 reported the missing items and did not log their missing items on inventory forms. Eleven (11) out of fourteen (14) residents interviewed reported no instances of theft or missing items. Based on interviews and record review, there was no evidence supporting a theft as opposed to items that went missing or were lost. The facility followed the theft an loss policy, made reasonable efforts to safeguard residents’ property, and attempted to reimburse residents for missing items. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

No immediate health and safety hazards were observed during this visit.

Exit interview conducted. Appeal rights discussed. Copy of report provided.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas Reed	TELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:	DATE: 12/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/27/2023

LIC9099 (FAS) - (06/04)

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