197608267-7-25-2023-31-AS-NMAN-CWFJYQ-20231009072818

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608267
Report Date: 07/25/2023
Date Signed: 07/25/2023 07:19:39 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
08/12/2022 and conducted by Evaluator Tihesha Smith

COMPLAINT CONTROL NUMBER: 31-AS-20220812144318

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: 140	DATE:	07/25/2023
		UNANNOUNCED	TIME BEGAN:	04:40 PM
MET WITH:	Aris Vergara		TIME COMPLETED:	07:25 PM

ALLEGATION(S):

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Staff do not ensure resident needs are met
Insufficient staffing to meet resident needs
Staff prevent resident from making decisions about care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tihesha Smith made an unannounced subsequent complaint visit to this facility at 4:40 pm. LPA Smith met with facility staff and the administrator was present at the facility. LPA Smith disclosed the purpose of this visit.
On 05/20/23, LPA Smith interviewed staff and residents from approximately 8:20 am - 11:30 am.

Staff do not ensure resident needs are met

It was alleged that staff do not ensure Resident # (R1) needs are met. Interviews with Executive Director and administrator conducted on 05/15/23 revealed that staff ensure R1 is provided any items and assistance needs. Interview with R1 revealed that they are able to receive assistance when they need it. R1 also reveal at this time all their needs are met and does not have any issues when staff. Interview with Seven (7) out eleven (11) residents reveal their needs are met and/or they don’t have any issues with their needs. Three (3) out of eleven (11) reveal wants are not met.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Tihesha Smith	TELEPHONE: 818-307-6280
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-20220812144318

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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(Cont from 9099)

Based on interviews during this and previous licensing visits there is insufficient pertinent information to support the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time

Insufficient staffing to meet resident needs

It was alleged that there is insufficient staffing to meet Resident # (R1) needs. Interviews with Executive Director, administrator and Wellness Director conducted on 05/15/23, 05/20/23 and 07/25/23 revealed that the caregivers assigned to R1’s area are trained on Hoyer lift on three shifts: AM/PM and Overnight. Interview with R1 revealed that they are able to receive assistance when transferring in and out of bed. R1 also reveal at this time all their needs are met and does not have any issues when staff. Interview with six (6) out of eleven (11) residents reveal there are enough staff present to meet thier needs.

Based on interviews during this and previous licensing visits there is insufficient pertinent information to support the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

Staff prevent resident from making decisions about care

It was alleged that staff prevent Resident (R1) from making decisions about care. Interview with R1 reveal they make most thier own decisions concerning affairs to include but not limited to medical and financial affairs. Interview with three (3) out of three (3) staff with specific knowledge related to R1s care and personal affairs reveal that R1 is alert and handles their own finances and medical appointments. Interview with six (6) out of eleven (11) residents reveal they make their own doctors’ appointments and decisions about care. Three (3) out of eleven (11) residents reveal staff make their appointments but they are involved with decisions about their care and are not prevented from making decision about thier care.

Based on interviews during this and previous licensing visits there is insufficient pertinent information to support the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

Exit interview conducted/Appeal/Copy of report given

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Tihesha Smith	TELEPHONE: 818-307-6280
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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