197608477-8-28-2024-31-AS-NMAN-D9ASBV-20240920134430

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608477
Report Date: 08/28/2024
Date Signed: 08/28/2024 03:38:43 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
03/25/2024 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20240325101907

FACILITY NAME:	IVY PARK AT STUDIO CITY		FACILITY NUMBER:	197608477
ADMINISTRATOR:	SHAHIN TAGHIZADEH		FACILITY TYPE:	740
ADDRESS:	4610 COLDWATER CANYON AVE		TELEPHONE:	(818) 505-8484
CITY:	STUDIO CITY	STATE: CA	ZIP CODE:	91604
CAPACITY:	121	CENSUS: 67	DATE:	08/28/2024
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Faraz Kashani, Executive Director		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff are abusing residents in care in the prescence of other residents.
Staff do not have adequate staffing to meet resident's needs.
Staff left residents unsupervised during shift.
Staff leave residents soiled for an extended period of time.
Staff does not provide adequate food service to residents.
Staff do not ensure residents attend scheduled doctor appointments.
Staff do not ensure facility is free of odor.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced subsequent complaint visit to this facility to investigate the above allegations. LPA met with Faraz Kashani and explained the reason for the visit.

--- Staff are abusing residents in care in the presence of other residents.

It was alleged that facility staff are aggressive with and abuse residents. To investigate the allegations, LPA conducted physical plant tour at around 10:00 AM and interviewed five (05) staff and one (01) resident between 11:30 AM to 04:30 PM. During the physical plant tour, LPA did not observe any signs of abuse and all residents were clean and well groomed. During interviews with staff, all staff stated that they are not aggressive or abusive towards residents and are not aware of any staff exhibiting such behaviors.

(CONT. on LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 5

Control Number 31-AS-20240325101907

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: IVY PARK AT STUDIO CITY	FACILITY NUMBER: 197608477
	VISIT DATE: 08/28/2024

NARRATIVE

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During interviews with residents, Resident #2 (R2) stated they do not feel staff are aggressive or abusive and have never witnessed staff abusing other residents or treating them aggressively. LPA was unable to interview other residents.

Based on observations and interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

--- Staff do not have adequate staffing to meet resident's needs.

It was alleged that memory care is regularly left with only one (01) caregiver available for the twenty-three (23) or so residents on that floor. To investigate the allegation, LPA conducted physical plant tour at around 10:00 AM, requested pertinent documents at 11:00 AM and interviewed five (05) staff and one (01) resident between 11:30 AM to 04:30 PM. During the physical plant tour, LPA observed three (03) caregivers and one (01) MedTech in the memory care section. A review of the staff schedule shows that there are at least three (03) caregivers and one (01) MedTech during the morning and afternoon shifts and at least two (02) caregivers during the overnight shift. During interviews with staff, all staff stated that there is always at least two (02) caregivers scheduled per shift and that there are more available during the morning and afternoon shifts. During interviews with residents, R2 stated they feel that facility has sufficient staffing. LPA was unable to interview other residents.

Based on observations, record reviews and interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

---Staff left residents unsupervised during shift.

It was alleged that on New Years Eve there was no care staff during the overnight shift. To investigate the allegations, LPA conducted a physical plant tour at around 10:00 AM, requested pertinent documents at 11:00 AM and interviewed five (05) staff and one (01) resident between 11:30 AM to 04:30 PM. During the physical plant tour, LPA observed three (03) caregivers and one (01) MedTech in the memory care section.

(CONT. on LIC9099-C)

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 31-AS-20240325101907

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: IVY PARK AT STUDIO CITY	FACILITY NUMBER: 197608477
	VISIT DATE: 08/28/2024

NARRATIVE

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A review of the staff schedule shows facility has a minimum two (02) caregivers per shift in memory care and one (01) Med Tech in the facility that alternates between assisted living and memory care. A review of the staff time sheets revealed there were two (02) caregivers in memory care for the entire shift during the period in question. During interviews with staff, three (03) out of five (05) staff stated they did not witness the overnight shift leaving residents unattended but heard about it through others. The remaining two (02) out of five (05) staff stated they are not aware of any residents being left unattended during the overnight shift. During interviews with residents, R2 stated they are not aware of ever being left unattended. LPA was unable to interview other residents.

Based on observations, record reviews and interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

---Staff leave residents soiled for an extended period of time.
---Staff do not ensure facility is free of odor.

It was alleged that Resident #1 (R1) is not getting sufficient incontinent care, staff are not cleaning resident’s room and room has malodor. To investigate the allegation, LPA conducted physical plant tour at around 10:00 AM and interviewed five (05) staff and one (01) resident between 11:30 AM to 04:30 PM. During the physical plant tour, LPA observed that all residents were clean and well groomed. LPA did not experience a malodor in Resident #1 (R1’s) room and the room was observed to be clean. During interviews with staff, all staff stated that residents are changed at least twice per shift and checked on every two hours. Staff added that all residents have housekeeping services, caregivers tidy up daily and malodor is experienced only when residents have a movement but that the odor is not constant. During interviews with residents, R2 stated they are changed frequently, are not left soiled for an extended time and does not experience malodor. LPA was unable to interview other residents.

Based on observations and interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

(CONT on LIC9099-C)

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 31-AS-20240325101907

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: IVY PARK AT STUDIO CITY	FACILITY NUMBER: 197608477
	VISIT DATE: 08/28/2024

NARRATIVE

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--- Staff does not provide adequate food service to residents.

It was alleged that facility serves food of a lesser quality to memory care residents when compared to the assisted living residents and that the foods are not fresh. To investigate the allegation, LPA conducted physical plant tour at around 10:00 AM and interviewed five (05) staff and one (01) resident between 11:30 AM to 04:30 PM. During the physical plant tour, LPA observed that both the memory care and assisted living residents have the same exact menus. LPA also observed that all foods were fresh and served timely. During interviews with staff, all staff confirmed that both menus are the same and that foods are served fresh. During interviews with residents, R2 stated they do not feel that they are being served food of a lesser quality and that the food is fresh. LPA was unable to interview other residents.

Based on observations and interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

--- Staff do not ensure residents attend scheduled doctor appointments.

It was alleged that there is regular last-minute cancellation of doctor appointments due to under staffing, and sometimes false reasons are provided to residents. To investigate the allegations, LPA interviewed five (05) staff and one (01) resident between 11:30 AM to 04:30 PM. During interviews with staff, all staff stated that residents do not regularly miss their doctors’ appointments and that if for whatever reason an appointment is missed, the facility helps with rescheduling their appointment. During interviews with residents, R2 stated they are not aware of regularly missed doctors’ appointments and does not experience last-minute cancellations. LPA was unable to interview other residents.

Based on interviews, there is not enough information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

No health and safety hazards noted during the visit.

Exit interview conducted. Copy of this report issued.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2024

LIC9099 (FAS) - (06/04)

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