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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608081
Report Date: 01/19/2024
Date Signed: 01/19/2024 11:20:33 AM

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
01/10/2024 and conducted by Evaluator Nicholas Reed
COMPLAINT CONTROL NUMBER: 31-AS-20240110095826
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: 134DATE:
01/19/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Joyce MartinezTIME COMPLETED:
11:25 AM
ALLEGATION(S):
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Staff did not ensure resident has access to a working telephone
INVESTIGATION FINDINGS:
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At approximately 9:30 a.m. on 01/19/2024, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced initial complaint visit. LPA met with the administrator and disclosed the reason for the visit.

To investigate the allegations above, LPA interviewed staff between 9:50 a.m. and 11:00 a.m., obtained pertinent records at 10:45 a.m., and toured the facility at 11:00 a.m.

Regarding the allegation “Staff did not ensure resident has access to a working telephone” it was alleged the memory care unit does not have a working phone, and when callers try to reach the memory care unit, the call gets disconnected. Prior to the visit, LPA called the facility at 9:00 a.m. today and confirmed the facility phone is operational. When attempting to connect to the memory care unit, the phone call was disconnected. LPA called again at 9:50 a.m. today and was connected to the memory care unit.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 01/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2024
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 3
Control Number 31-AS-20240110095826
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: 01/19/2024
NARRATIVE
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 LPA spoke with Staff #1 (S1) in the memory care unit who explained that calls may be delayed if another resident is using the line. At 10:40 a.m. today LPA was able to call out from the facility phone. At 10:45 a.m. today, Staff #2 (S2) told LPA that the memory care unit phone was recently misplaced by a resident. The facility promptly replaced the phone. Based on interviews and observations, the facility phone is operational. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

No immediate health and safety hazards were observed during today’s visit.

Exit interview conducted. Appeal rights discussed. Copy of report provided.
SUPERVISOR'S NAME: Naira MargaryanTELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas ReedTELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:

DATE: 01/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3