197608267-7-25-2023-31-AS-NGID-CUHMKL-20230808094051

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608267
Report Date: 07/25/2023
Date Signed: 07/25/2023 02:10:09 PM

Unsubstantiated

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
01/04/2022 and conducted by Evaluator Melissa Ruiz

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20220104133216

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: 130	DATE:	07/25/2023
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Aris Vergara & Kandace Williams		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Facility staff sexually abused resident
Staff inappropriately kissed resident
Facility is not allowing visit due to COVID
Staff handle resident roughly
Staff speak inappropriately to a resident
Facility does not keep residents room free from mold
Staff do not safeguard resident's property
Resident was not given breakfast

INVESTIGATION FINDINGS:

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On 7/25/2023, Licensing Program Analyst (LPA) Melissa Ruiz at 12:00 p.m. and arrived at the facility to amend this report. LPA amended this report to add more information such as resident interviews and physical plant observations pertaining to the allegations listed on this complaint. On 12/21/2022, Licensing Program Analysts (LPAs) Melissa Ruiz and Joscelyn Martinez arrived at the facility to conduct a subsequent complaint visit. Upon arrival, LPAs were greeted by staff and later met with Administrator "Aris". An entrance interview was conducted, and the purpose of the visit was explained.

Facility is not allowing visit due to COVID.

An interview with the Administrator held at approximately 11:30 a.m. revealed that the Los Angeles County Public Health issued an Order instructing the facility to go into lockdown and deny visitation due to continuous active covid-19 outbreaks, ranging from different dated within the span of August 2021 – January 2022. (cont. on LIC9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Melissa Ruiz	TELEPHONE: (818) 401-7980
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2023

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-20220104133216

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: 07/25/2023

NARRATIVE

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At the time of this visit, LPA reviewed and collected LACDPH covid-19 outbreak notifications and clearance letters to corroborate the Administrator’s statement. Due to this information, the allegation mentioned above is Unsubstantiated.

Facility staff sexually abused resident
Staff inappropriately kissed resident

On 1/26/2022, Investigator Garcia conducted interviews with one resident (R1), two facility staff, and R1’s family member. An interview with R1 revealed that R1 denied being sexually abused by staff or being kissed by staff. R1 did state that they prefer female staff assisting them with hygiene needs, due to them being “very conservative”. An interview with R1’s family member revealed that they do not believe that R1 has been sexually molested or abused, and stated that due to R1’s condition, R1 misinterprets a lot of things. Interviews with two (2) staff members revealed that both denied ever witnessing or hearing about sexually abuse allegations. Due to interviews conducted, the allegations listed above are Unsubstantiated at this time.

Staff handle resident roughly
Staff speak inappropriately to a resident

On 1/26/2022, Investigator Garcia conducted interviews with one resident (R1), two facility staff, and R1’s family member. One staff member (S1) stated that there were times where two staff members would assist and change R1, but that R1 did not like either of those staff members due to their sexual orientation or physical appearance. An interview conducted with R1 revealed that R1 only wants female staff to change them and prefers one specific staff member. Interviews with two facility staff members revealed that there are always two staff present when changing resident’s diapers or hygiene needs. An interview with R1’s family member revealed that R1 tends to “hold onto grudges” and always brought stuff up from other board and care homes, and other staff members alleging similar accusations of being treated roughly or disrespectfully. During today’s visit, LPAs interviewed one staff member (S3) related to this allegation, who provided care for R1. S3 denied treating R1 in a rough manner or speaking inappropriately to R1. On 7/25/23 LPA interviewed out of 13 residents from 12:00 – 1:20 p.m. and 13 out of 13 residents stated that they have not had staff handle them in a rough manner. 13 out of 13 residents stated that no staff have spoken inappropriately to residents in care and are happy with the staff.

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Melissa Ruiz	TELEPHONE: (818) 401-7980
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2023

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20220104133216

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: 07/25/2023

NARRATIVE

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Due to interviews conducted, there is not sufficient evidence to prove the allegation mentioned above may or may not have happened, therefore it is deemed Unsubstantiated.

Facility does not keep residents’ room free from mold.

During different visits conducted by LPA Martinez ranging from March – October 2022, LPA Martinez conducted physical plant tour and LPA specifically toured R1’s bedroom. During various visits, LPA Martinez did not observe any wall or window to have mold. LPAs interviewed the Administrator, and Administrator stated that there were never any reports of mold on the walls or windows made by R1 or staff. The only issue in R1’s room was a leak which was already being fixed. On 7/25/23 LPA interviewed 13 out of 13 residents from 12:00 – 1:20 p.m. and 13 out of 13 residents stated that they do not have issues with mold in the room. Additionally, during a physical plant tour today, LPA did not observe any mold in resident rooms. Due to interviews conducted, this allegation is deemed Unsubstantiated.

Staff do not safeguard resident's property.

It is alleged that R1 had personal items such as clothing, and valuables go missing. LPA collected R1’s Client/Resident Personal Property and Valuables (LIC 621). R1 did not have any property listed on the LIC 621 and the form had R1’s signature stating they did not want to log any property. An interview was conducted with the Administrator, and the Administrator stated that to their knowledge, no staff have lost, stolen or misplaced any of R1’s items. Administrator stated that staff would assist R1 with storing their beverages, and R1 would often state that their beverages would go missing. However, Administrator does not believe any staff have stolen any of R1’s items. On 7/25/23 LPA interviewed 13 out of 13 residents from 12:00 – 1:20 p.m. and 13 out of 13 residents stated that they have not had any issues with their personal belongings or issues with staff safeguarding their property. Based on interviews and document review this allegation is deemed Unsubstantiated at this time.

Resident was not given breakfast

On 1/26/2022, Investigator Garcia conducted interviews with one resident (R1), two facility staff, and R1’s family member. In an interview conducted with R1, R1 stated that their only issue is that they do not like the food the facility provides, because it is not to their standards. R1 stated they have their own fridge and R1’s friends bring them food sometimes. R1 did not mention anything regarding not receiving breakfast meals but expressed their dislike of the food service.

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Melissa Ruiz	TELEPHONE: (818) 401-7980
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2023

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20220104133216

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: 07/25/2023

NARRATIVE

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An interview with one staff member (S1) revealed that there is a food menu and an alternate menu provided to all residents. Additionally, residents have the choice to ask family or friends to bring them their own food. On 7/25/23 LPA interviewed 13 out of 13 residents from 12:00 – 1:20 p.m. and 13 out of 13 residents stated that they are always given the option to have breakfast. Due to interviews conducted, there is not sufficient evidence to prove the allegation mentioned above may or may not have happened, therefore it is deemed Unsubstantiated.

Resident does not have access to call button.

LPAs interviewed the Administrator and asked if there was ever an instance where R1 did not have access to their call button. Administrator stated R1 always had access to their call button. During different visits conducted by LPA Martinez ranging from March – October 2022, LPA Martinez conducted physical plant tours. LPA specifically toured R1’s bedroom and always observed the pull cord to be over R1’s bed and accessible to R1. On 7/25/23 LPA conducted a physical plant tour at approximately 12:00 p.m. and observed resident rooms to have their call light button directly above their bed. LPA interviewed 13 out of 13 residents from 12:00 – 1:20 p.m. and 13 out of 13 residents stated that they have access to their call light and string. Due to the interview with the Administrator and observation, the allegation mentioned above is Unsubstantiated at this time.

Report was signed and delivered. Exit interview conducted. No deficiencies issued.

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Melissa Ruiz	TELEPHONE: (818) 401-7980
LICENSING EVALUATOR SIGNATURE:	DATE: 07/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2023

LIC9099 (FAS) - (06/04)

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