197608267-7-1-2020-31-AS-JAPL-BUVQH3-20201030121025

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608267
Report Date: 07/01/2020
Date Signed: 07/01/2020 04:55:48 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
06/05/2020 and conducted by Evaluator Mita Amin

COMPLAINT CONTROL NUMBER: 31-AS-20200605155956

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: 111	DATE:	07/01/2020
		UNANNOUNCED	TIME BEGAN:	10:44 AM
MET WITH:	Aris Vergara/ Administrator		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Food served is not of good quality and quantity to meet residents needs
Residents do not have access to drinking water and ice
Facility does not provide a comfortable accommodations

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mita Amin conducted tele-visit for a complaint investigation for the allegation listed above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s complaint investigation was conducted telephonically with Aris Vergara, the facility administrator.

Concerns was expressed that the facility staff are not providing good quality and quantity of food to meet residents needs.

To investigate the allegation LPA conducted virtual visit on 6/11/20 at 12:40 pm, interviewed the cook and the staff members present at the time. On 6/30/20 LPA spoke with Resident Coordinator and Wellness Coordinator at 10:42am. LPA requested and obtained the facility menus reviewed on 6/11/20 at 3 pm.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Mita Amin	TELEPHONE: (818) 421-6459
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2020

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-20200605155956

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: 07/01/2020

NARRATIVE

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During virtual tour the LPA observed the kitchen and food storage areas, which included a sufficient supply of fresh fruits and vegetables, frozen vegetables and a variety of dinner items. The LPA observed the lunch plate they were serving for lunch that particular day was the one on their weekly menu, chicken Alfredo, carrots and peas with garlic bread with cookies. The LPA also observed water bottles and variety of fruit juices. Due to the COVID situation residents receive the tray service. Kitchen staff prepares the plate, wrap it with the plastic to keep the food warm. Caregivers delivers the meal to the residents in their respective rooms. Caregiver also carry 3 types of juice pitchers and provide each resident a juice or drink of their choice in the room.

Based on the interview with the staff and administrator, sometimes resident is not present in their room at the meal time delivery, caregiver had to leave their plate in the room. As per staff by the time food might be cold. They do have a choice to call the caregiver to warm up the food again. Administrator stated they try their best to minimize the time between plates being prepared in the kitchen and the delivery, to preserve the quality of food. Regarding seconds, residents has a choice to call the front desk or pull the cord from the room so staff can bring them whatever they need. Administrator stated they have not observed any weight loss due to the controlled portion of the food. They have not heard any concern from the medical professional about resident losing weight in last 3 months since the COVID restriction has been implemented. Administrator added they are not aware of any concerns from the residents about the food services at this time.

On 6/10/20 at 3:33 pm, LPA spoke with the complainant, who also stated the resident#1 did not seem malnourished during their visit.

Based on the observation during the virtual visit and the interviews the LPA has determined the allegation
of "Food served is not of good quality and quantity to meet residents needs" is deemed unsubstantiated at this time.

-Residents do not have access to drinking water and ice

To investigate the above allegation LPA conducted virtual visit on 6/11/20 at 12:40 pm, interviewed the cook and the staff members present at the time. On 6/30/20 LPA spoke with Resident Coordinator and Wellness Coordinator at 10:42am.

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Mita Amin	TELEPHONE: (818) 421-6459
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2020

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20200605155956

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: 07/01/2020

NARRATIVE

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During the virtual tour of the facility LPA noticed facility do not have hydration station due to the COVID situation. Based on the interviews with the staff every residents gets the drink of their choice with their meals in the room, 3 times a day and have their snacks and water in between the meals. Residents are encouraged to call front desk or pull the cord from the room to call the caregiver if they need extra water or ice. Some residents are getting their own pitcher and wanted staff to fill it up with water and ice for all day supply, but that is their choice.

Based on the observation and interviews, the LPA has determined the allegation of "Residents do not have access to drinking water and ice" is deemed unsubstantiated at this time.

-Facility does not provide a comfortable environment for resident.

To investigate the allegation LPA conducted virtual visit on 6/11/20 at 12:40 PM, interviewed the cook and the staff members present at the time. On 6/30/20 LPA spoke with Resident Coordinator and Wellness Coordinator at 10:42am.

Reporting party stated that facility does not have sufficient furniture. Due to the COVID situation facility removed the furniture from the common area and just have few chairs. Most of the residents preferred to stay in their room but some residents comes to smoke so they have few chairs 6 feet apart in smoking area. They do have many smokers but they encourage them to keep the distance. During the virtual tour LPA observed four chairs, 6 feet apart in smoking area, however there was only one resident present.

Based on the observation and considering the COVID situation at this time the above allegation "Facility does not provide a comfortable environment for resident" is deemed unsubstantiated. No deficiency issued.

A telephonic exit interview was conducted with Mr.Vergara and a hard copy was provided via email for signature.

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Mita Amin	TELEPHONE: (818) 421-6459
LICENSING EVALUATOR SIGNATURE:	DATE: 07/01/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2020

LIC9099 (FAS) - (06/04)

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