197608081-3-1-2024-31-AS-NMAN-D9MRB3-20241001125205

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608081
Report Date: 03/01/2024
Date Signed: 03/01/2024 04:08:55 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
02/23/2024 and conducted by Evaluator Nicholas Reed

COMPLAINT CONTROL NUMBER: 31-AS-20240223083524

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:	03/01/2024
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Carolina Garcia-Trejo		TIME COMPLETED:	04:10 PM

ALLEGATION(S):

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Staff do not assist resident with obtaining medical care
Staff did not provide resident with a notice of rate increase
Staff are charging resident for unspecified fees
Staff do not assist resident with showering
Staff do not assist resident with grooming
Staff are not providing a comfortable environment for resident

INVESTIGATION FINDINGS:

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At 10:30 a.m. on 03/01/2024, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced subsequent complaint visit. LPA met with the Executive Director (ED) and disclosed the reason for the visit.

To investigate the allegations above, LPA conducted an initial visit on 02/29/2024 and interviewed the ED at 11:00 a.m., Staff #1 (S1) at 11:15 a.m., Staff #2 (S2) at 11:30 a.m., Resident #2 (R2) at 1:00 p.m., and attempted to interview Resident #1 (R1) at 12:45 p.m. LPA conducted a records review at 11:45 a.m. today of records including but not limited to the identification form, admission agreement, care plan, medical assessment, police report, and outstanding rental bill, toured the physical plant at 1:00 p.m., and interviewed Staff #3 (S3) at 1:15 p.m. LPA also attempted to interview R1 at 1:05 p.m. today. R1 declined to be interviewed again.

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: 03/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2024

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-20240223083524

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: 03/01/2024

NARRATIVE

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Regarding the allegation “Staff do not assist resident with obtaining medical care" it was alleged the facility did not provide advanced notice to R1 before their medical appointments. Interview with S2 revealed R1 requested medical appointments, so the facility arranged vision, dental, and medical appointments outside of the facility for R1. R1 refused to attend the appointments. S2 then arranged for an optometrist service, a dentist, and a podiatrist to come to the facility to assist R1. R1 again refused to attend the appointments. S2 asked R1 the reason for refusing the appointments, and R1 stated they do not need the appointments and they are fine as they are. R1 declined to be interviewed by LPA at 12:45 p.m. on 02/29/2024 and today at 1:05 p.m. Based on interviews, the facility assisted R1 with obtaining medical care. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Regarding the allegation “Staff did not provide resident with a notice of rate increase” it was alleged the facility did not provide sufficient notice prior to issuing an increase to R1’s rent. Interview with the ED revealed all residents were notified of the annual rental increase on 11/28/2023. Record review revealed that on 11/28/2023, the Department of Social Services issued Provider Information Notice (PIN) 23-20-CCLD detailing the estimated Social Security Income (SSI) payment standards for 2024. Review of R1’s monthly charges revealed the facility charged R1 rent in accordance with the Department’s guidelines. Interview with S1 revealed R1 has the money to pay the rent but has not paid the full rent. Based on interviews and record review, R1 was provided notice of the annual rent increase. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Regarding the allegation “Staff are charging resident for unspecified fees” it was alleged the facility did not provide an explanation for the increased rent. Record review revealed the letter issued by the ED on 11/28/2023 detailed the reason, amount, and effective date of the rent increase for all participating residents. The letter also described the charges for Room and Board, Care and Supervision, and the Personal and Incidental Needs Allowance. Review of R1’s monthly charges showed R1 was charged the rate explained on the rent increase letter. Interview with ED confirmed the details of the letter. Also, besides the standard annual rent increase, R1 was not being charged any additional or unexplained fees. Based on interviews and record review, R1 was provided notice of the annual rent increase. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas Reed	TELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20240223083524

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: 03/01/2024

NARRATIVE

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Regarding the allegations “Staff do not assist resident with showering” and “Staff do not assist resident with grooming” it was alleged staff do not assist R1 with showers and grooming prior to their medical appointments. Interview with S2 revealed R1 was difficult to work with as they repeatedly refused assistance with bathing and grooming. R1 also refused to participate in bathing and grooming. S2 expressed concerns for R1’s hygiene to R1’s family. R1’s family told S2 to try to influence R1 more. S3 confirmed that R1 frequently refuses assistance and requests to bathe and groom. Based on interviews, staff offer assistance with showering and grooming but R1 refuses assistance. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

Regarding the allegation “Staff are not providing a comfortable environment for resident” it was alleged R1 was not allowed to open the blinds in their room for natural light or turn on their lamp. LPA toured R1’s room at 12:45 p.m. on 02/29/2024 and saw the blinds open with natural light filling the room. During today’s tour, LPA saw the blinds were closed. Interview with R1’s roommate R2 revealed they had no issue with R1 opening the blinds or turning on lights. Each resident has a personal lamp, and there is a shared overhead light for the room. R1 again declined to be interviewed. Interviews with the ED, S1, and S2 revealed they had not heard any concerns expressed by R1 regarding the lighting of their room. S3 stated R1 likes the room lit up, and R2 likes the blinds closed. Based on observations and interviews, R1 was allowed to use their light and open the blinds. Therefore, the allegation is deemed UNSUBSTANTIATED at this time.

No immediate health or safety concerns were observed during this visit.

Exit interview conducted. 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: 03/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2024

LIC9099 (FAS) - (06/04)

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