197608267-3-12-2024-31-AS-MVAO-D3XT9K-20240402143203

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608267
Report Date: 03/12/2024
Date Signed: 03/12/2024 11:49:13 AM

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
06/30/2023 and conducted by Evaluator Gina Saucedo

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20230630105843

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: 120	DATE:	03/12/2024
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Resident Care Director		TIME COMPLETED:	11:55 AM

ALLEGATION(S):

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Staff do not prevent residents from smoking in nonsmoking areas

INVESTIGATION FINDINGS:

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On 03/12/24, at 8:50am, 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 disclosed the purpose of the visit. LPA explained the purpose of this visit was to gather additional information, conduct more interviews and deliver findings for this complaint.

On 07/05/2023, LPA Melissa Spaeth initiated the complaint investigation. The investigation consisted of the following: LPA Saucedo asked for the census, requested the staff and resident roster. At 9:30am, LPA toured the physical plant. During the tour, twelve (12) residents and three (3) additional staff were interviewed.

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: 03/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2024

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-20230630105843

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: 03/12/2024

NARRATIVE

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Regarding the allegation: Staff do not prevent residents from smoking in nonsmoking areas. It is being alleged that facility staff are allowing residents to smoke in areas of the facility that are designated as nonsmoking. LPA was able to obtain three (3) different thirty (30) day eviction warning letters given to three (3) different residents warning them of House Rules/Facility Policy of The Community pertaining to no smoking in certain areas. During LPA’s physical tour, LPA was able to interview twelve (12) out of twelve (12) residents that have confirmed that they are aware of the non-smoking signs in several different areas of the facility. LPA interviewed smoking and non-smoking residents. LPA was able to observe six (6) different signs posted in different areas of the facility that stated "no smoking area". LPA obtained all six (6) pictures/postings: There was two (2) posted in the front of the facility. There was one (1) on the door of the dining hall, one (1) on a room door down the hallway displaying danger oxygen in use, One (1) against the wall of the patio area and another one (1) with a standing sign along the patio area. The resident care director also showed LPA where the residents are allowed to smoke. LPA took a picture of the designated smoking area for residents where there are several ash tray bins for cigarette butts. LPA was also able to interview three (3) additional staff that confirmed the smoking/non-smoking areas. Therefore, based on the LPA's interviews, observations, and record reviews the above allegation(s) above is unsubstantiated at this time.

SUPERVISOR'S NAME: Troy Agard	TELEPHONE: (818) 596-4334
LICENSING EVALUATOR NAME: Gina Saucedo	TELEPHONE: (818) 304-3057
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2024

LIC9099 (FAS) - (06/04)

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