197608267-11-25-2024-31-AS-RORN-DC2VSA-20241217154113

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608267
Report Date: 11/25/2024
Date Signed: 11/25/2024 01:13:31 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
11/08/2024 and conducted by Evaluator Gina Saucedo

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20241108145353

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: 110	DATE:	11/25/2024
		UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Mary Jane Reyes, Resident Care Director		TIME COMPLETED:	01:20 PM

ALLEGATION(S):

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Staff do not provide an appropriate sleeping arrangement for a resident
Staff do not address a resident's change in medical condition
Staff are mistreating a resident
Staff do not provide comfortable accommodations for a resident

INVESTIGATION FINDINGS:

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On 11/25/24, at 9:10am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, subsequent complaint visit and was greeted by Resident Care Director, Mary Jane Reyes. LPA explained the purpose of this visit was to gather additional information and deliver findings for this complaint.

On 11/13/24, LPA Saucedo asked for the census, staff, and resident rosters. On 11/13/24, LPA Saucedo interviewed staff and conducted a physical tour. On 11/25/24, LPA Saucedo conducted another physical tour and interviewed additional staff and residents.

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: 11/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2024

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-20241108145353

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: 11/25/2024

NARRATIVE

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Regarding the allegation: Staff do not provide an appropriate sleeping arrangement for a resident. It is being alleged that resident #1 (R1) does not have a bed and that they have been sleeping on a chair. During LPA’s physical tour, LPA observed a bed in R1’s room and took a picture of it. During LPA’s interview with R1, R1 stated that they have a bed but not a bed like what they had at their previous facility which had handrails and would like a similar bed, therefore; they choose to sleep in a chair that was in the room. During LPA’s interview with Resident #2 (R2), R2 stated that the chair R1 is sleeping on belongs to them and R1 is choosing not to sleep on their bed. Let it be noted, R1 and R2 are roommates. Eleven (11) residents confirmed that they all have somewhere to sleep including a bed to sleep on. Two (2) staff confirmed that R1 does have a bed to sleep on. One (1) staff confirmed that when R1 arrived they did not bring a bed with them, so a bed was provided for them. Therefore, based on the LPA's observations, staff, and resident interviews the above allegation(s) above is UNSUBSTANTIATED at this time.

Regarding the allegation: Staff do not address a resident's change in medical condition. It is being alleged that resident #1 (R1) is in pain, has several areas of their body swollen and uses their commode to help them stand on their feet. During LPA’s record review, R1 has several medical conditions including osteoarthritis and polyneuropathy and there has been no recent change in their medical condition. During LPA's physical tour of R1's room, R1 has a an adjustable walker to help them stand on their feet, they do not have to use a commode. LPA took a picture of the adjustable walker. During LPA’s interview with R1, R1 confirmed that their legs and feet were already swollen when they arrived at the above facility. R1 is currently at a skilled nursing facility due to their current medical condition being addressed at the above facility. Be advised, R1’s admission to the above facility was on 11/01/24 then had to be transferred to a hospital a couple days later due to unusual behaviors including a urinary tract infection. One (1) staff confirmed that on 11/09/24, R1 was sent to the hospital and was then transferred to a skilled nursing facility for treatment. Furthermore, another staff confirmed that when R1 arrived at the above facility, R1 had swollen legs and feet. Ten (10) out of eleven (11) residents confirmed that if changes occur to their medical condition it is addressed at the above facility. Therefore, based on the LPA's record reviews, staff, and resident interviews the above allegation(s) above is UNSUBSTANTIATED at this time.

LIC 9099C-continued

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) 596-4334
LICENSING EVALUATOR NAME: Gina Saucedo	TELEPHONE: (818) 304-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 11/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2024

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20241108145353

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: 11/25/2024

NARRATIVE

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Regarding the allegation: Staff are mistreating a resident. It is being alleged that resident #1 (R1) is not being treated well and has asked for a social worker. During LPA’s interview with R1, R1 stated they have a social worker but cannot get in contact with them since they arrived at the above facility. R1 wants to get in contact with them so they can receive everything they had the previous facility. R1 wants a bed with handrails, wants all their property from the previous facility and everything stated in their Assisted Living Waiver paperwork. One (1) staff confirmed that R1 has a social worker, but the social worker has not been returning their calls including R1’s calls. Furthermore, R1 will receive a new case worker since R1’s Assisted Living Waiver is being updated. Ten (10) out of eleven (11) residents confirmed that staff do assist and provide them with necessary help and do not mistreat them. Therefore, based on the LPA's record reviews, staff, and resident interviews the above allegation(s) above is UNSUBSTANTIATED at this time.

Regarding the allegation: Staff do not provide comfortable accommodations for a resident. It is being alleged that the room resident #1 (R1) is currently in has a freezing temperature. During LPA’s physical tour, LPA observed the room temperature in R1’s room to be with Title 22 regulations, it was 71 degrees in the room in which R1 shares with someone else. Furthermore, R1 and their roommate have a portable heater. Ten (10) out of eleven (11) residents confirmed that they are provided with comfortable accommodations. Ten (10) out of eleven (11) residents confirmed that they do not have any problems with their room temperature. Two (2) staff confirmed that room temperatures vary by resident’s room but also that the room temperature can be adjusted. Therefore, based on the LPA's observations, staff, and resident interviews the above allegation(s) above is UNSUBSTANTIATED at this time.

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

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) 596-4334
LICENSING EVALUATOR NAME: Gina Saucedo	TELEPHONE: (818) 304-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 11/25/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/25/2024

LIC9099 (FAS) - (06/04)

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