197608267-7-8-2024-31-AS-TAGD-D83SCK-20240812134536

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608267
Report Date: 07/08/2024
Date Signed: 07/08/2024 02:17:07 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.RO, 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
07/02/2024 and conducted by Evaluator Gina Saucedo

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20240702163246

FACILITY NAME:	CEDARS ASSISTED LIVING, THE		FACILITY NUMBER:	197608267
ADMINISTRATOR:	KANDICE VERGARA		FACILITY TYPE:	740
ADDRESS:	17300 ROSCOE BLVD.		TELEPHONE:	(818) 344-2042
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91325
CAPACITY:	175	CENSUS: 124	DATE:	07/08/2024
		UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Mary Jane Reyes		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff disturb resident’s sleep
Staff make inappropriate comments to resident

INVESTIGATION FINDINGS:

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On 07/08/24, at 9:25am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, subsequent complaint visit and was greeted by Mary Jane Reyes, Resident Care Director. LPA explained the purpose of this visit was to gather additional information and deliver findings for this complaint.

On 07/03/2024, LPA Gina Saucedo initiated the complaint investigation. On 07/03/24, LPA Saucedo asked for the census, staff, and resident roster. On 07/03/24, LPA Saucedo interviewed staff and residents and conducted a physical tour. On 07/08/24, at 9:55am, LPA conducted another physical tour with Resident Care Director, gathered additional information and conducted more interviews.

LIC 9099C-continued

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) 596-4334
LICENSING EVALUATOR NAME: Gina Saucedo	TELEPHONE: (818) 304-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2024

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-20240702163246

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: CEDARS ASSISTED LIVING, THE	FACILITY NUMBER: 197608267
	VISIT DATE: 07/08/2024

NARRATIVE

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Regarding the allegation: Staff disturb resident’s sleep. It is being alleged that resident's sleep is being disturbed. Twelve (12) out of twelve (12) residents confirmed that they have a roommate that is incontinent or/and that need help. In addition, Resident #1 (R1) has asked to be moved three times because they wanted to be closer to the Wi-Fi connection. R1's admission agreement also states that they have agreed to have a shared room. Four (4) out of Four (4) staff also confirmed that more than ninety-five percent of their residents require some type of help, and the caregivers/housekeepers will be in and out of the resident's room several times a day. During LPA's physical tour, LPA did observe several residents that require some type of help showering, in and out bed access, personal hygiene, hair care, wheelchair, walker and/or cane assistance. Therefore, based on the LPA's observations, staff, and resident interviews the above allegation(s) is UNSUBSTANTIATED at this time.

Regarding the allegation: Staff make inappropriate comments to resident. It is being alleged that staff are saying inappropriate comments to resident, trying to provoke them. Eleven (11) out of twelve (12) residents confirmed that staff speak to them in an appropriate manner. Four (4) out of four (4) staff confirmed that they try their best to help all residents in care and do not say inappropriate comments. During LPA's physical tour, LPA did not observe any staff saying inappropriate comments to the residents in care. Therefore, based on the LPA's observations, staff, and resident interviews the above allegation(s) is UNSUBSTANTIATED at this time.

An exit interview was conducted, no citation(s) were issued for the above allegations, and a copy of this report was given to the Administrator.

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) 596-4334
LICENSING EVALUATOR NAME: Gina Saucedo	TELEPHONE: (818) 304-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2024

LIC9099 (FAS) - (06/04)

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