197608267-6-23-2021-31-AS-MVAO-CD7VVE-20220405164614

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608267
Report Date: 06/23/2021
Date Signed: 06/23/2021 01:03:42 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
06/02/2021 and conducted by Evaluator Alexander Pitz

COMPLAINT CONTROL NUMBER: 31-AS-20210602162702

FACILITY NAME:	CEDARS ASSISTED LIVING, THE		FACILITY NUMBER:	197608267
ADMINISTRATOR:	ARISTOTLE B. VERGARA		FACILITY TYPE:	740
ADDRESS:	17300 ROSCOE BLVD.		TELEPHONE:	(818) 344-2042
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91325
CAPACITY:	175	CENSUS: 107	DATE:	06/23/2021
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Aris Vergara		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Facility staff is providing medical care to residents in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Pitz conducted an unannounced visit on this day in response to the above allegation.

As part of this investigation, LPA reviewed a random sampling of client records and interviewed three staff members on 6/10/21. On 6/16/21 LPA interviewed 5 residents. On 6/23/21 LPA interviewed two additional residents, three resident responsible parties, and Doctor Eyal Shtorch.

Allegation #1, that "Facility staff is providing medical care to residents in care" has been unsubstantiated based on the interviews conducted. 7/7 of the residents interviewed on 6/16/21 and 6/23/21, and 3/3 of the responsible parties interviewed on 6/23/21, either stated that they had never been visited by this doctor, he was already their pre-existing doctor, or that it was an optional, free service provided by the facility.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Alexander Pitz	TELEPHONE: (805) 450-1627
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2021

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-20210602162702

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: CEDARS ASSISTED LIVING, THE	FACILITY NUMBER: 197608267
	VISIT DATE: 06/23/2021

NARRATIVE

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All three staff interviewed on 6/10/21 stated that Dr. Eyal and his Nurse Practitioner Monica Keh do visit the facility to conduct assessments and update client medications as necessary, but that this is an optional service that nobody is charged extra for or obligated to participate in. Neither is providing direct patient care for restricted or prohibited health conditions.

At 12:40pm LPA spoke with Dr. Eyal telephonically. He confirmed that he and Monica Keh do visit this facility and others, mainly to visit existing patients of theirs and to provide assessments and make changes to medications for residents that do not have another form of Primary Care Physician.

Report reviewed, signed and delivered. Exit interview conducted, no deficiencies cited.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Alexander Pitz	TELEPHONE: (805) 450-1627
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2021

LIC9099 (FAS) - (06/04)

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