197609826-3-21-2023-31-AS-NMAN-CRURX6-20230515132410

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609826
Report Date: 03/21/2023
Date Signed: 03/21/2023 12:18:01 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
01/20/2023 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20230120082038

FACILITY NAME:	GARDEN OF PALMS		FACILITY NUMBER:	197609826
ADMINISTRATOR:	GINSBURG, MENACHEM		FACILITY TYPE:	740
ADDRESS:	1025 N FAIRFAX AVE		TELEPHONE:	(323) 656-7900
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90046
CAPACITY:	130	CENSUS: 64	DATE:	03/21/2023
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Nirjara Acharya, Executive Director		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Illegal eviction

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Abeye Duguma conducted subsequent visit to the facility to deliver addendum of the complaint report previously issued to the facility on 01/26/2023.
LPA Met with the Executive Director (ED) and informed the purpose of this visit.

Upon further review of available information and records, the report was amended to change final findings for the complaint investigation.
On 01/26/2023 at 10:45am, Licensing Program Analyst (LPA) LaQueena Lacy conducted an unannounced initial 10day complaint visit to the facility to investigate the above allegation. During the visit, LPA Lacy conducted a physical plant tour at 10:52am.

It is alleged that the facility issued a 30day eviction notice to the resident #1 (R1) for nonpayment of partial rent, subsidize by the Assisted Living Waiver (ALW) program.
(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: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

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-20230120082038

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: GARDEN OF PALMS	FACILITY NUMBER: 197609826
	VISIT DATE: 03/21/2023

NARRATIVE

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To investigate the above allegation, On -01/26/2023 LPA requested copies of document relevant to the investigation at approximately 11:38am. LPA interviewed staff and R1 at approximately 11:20am. R1 confirmed that he has not paid rent since moving into the facility in July of 2022 due to waiting for assistance from the Assisted Living Waiver Program and the remaining portion of rent was to be paid through his medical insurance program. Interviews with S1 confirmed that R1 had not paid rent for few months and the facility did issue an eviction notice for nonpayment of rent.

Upon review of R1’s admission agreement, it was noted that R1’s monthly fee to facility is $5,776.77 out of which $2,211.77 is the portion that should be paid by R1 and the rest of the fees is subsidized by ALW program. A review of the eviction notice revealed that R1 is in default of their portion of payment for six months. There was no indication of nonpayment of fees from the ALW program. Investigation revealed that R1 is being evicted for nonpayment of their portion of rent, which is a sufficient legal reason to serve an eviction notice.

Based on interviews and record review there is no information and evidence to support the allegation of “Illegal eviction”. Therefore, the allegation is Unsubstantiated at this time.

During this visit LPA Lacy discussed Title 22 Regulation and H&S Code pertaining the Eviction notices and specific information that must be included in the notices. Advisory note was served to the ED at the time of this visit.
Exit interview was conducted and copy of this report was issued.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Abeye Duguma	TELEPHONE: (818) 669-6814
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2023

LIC9099 (FAS) - (06/04)

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