197609826-5-25-2023-31-AS-NGID-D2TMWT-20240226085849

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609826
Report Date: 05/25/2023
Date Signed: 05/25/2023 08:26:03 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
02/16/2023 and conducted by Evaluator Angela Panushkina

COMPLAINT CONTROL NUMBER: 31-AS-20230216151130

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: 78	DATE:	05/25/2023
		UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Rena Hirsch, Ambassador		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Facility has pest infestation
Resident's personal rights were violated
Unlawful eviction
Facility staff inappropriately referring resident(s) to Home Health / Hospice
Facility has inadequate food supply
Facility is mishandling resident(s) monies.
Facility has no first aid supplies

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angela Panushkina conducted an unannounced subsequent visit at this facility to deliver final findings. LPA met with the Administrator and explained the reason for the visit.

During the initial visit made on 02/24/23 by LPA Panushkina, LPA conducted physical plant tour at 11:00am, reviewed facility files and obtained copies of pertinent documents relevant to the investigation. LPA also conducted interview with staff and residents of the facility, between 11:30am to 3:00pm.

Allegation: Facility has pest infestation
LPA record review revealed that the facility has a pest control company who visits the facility twice a week to ensure that there is no infestation of any kind, inside and outside of the facility within the vicinity. During the initial visit, LPA conducted interviews with four (4) residents, and interview revealed that they were not aware
Continue on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Angela Panushkina	TELEPHONE: 747-230-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023

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 4

Control Number 31-AS-20230216151130

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: 05/25/2023

NARRATIVE

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of any pest infestation nor did they see any rodents within the vicinity. Based on the information gathered during the initial visit, this allegation is deemed Unsubstantiated.

Allegation: Resident's personal rights were violated

It was alleged that the Dementia residents are forced to sign documents when they are not cognizant of what they are signing. To investigate this allegation LPA conducted interviews (during the initial visit) with the facility Ambassador, two (2) MedTechs, facility Physician, three family members and reviewed facility records. Interview with the Ambassador and two (2) MedTechs revealed that the facility will always provide at least three (3) choices to the residents and their families for Hospice and Home Health services. All staff members denied ever forcing or witnessing other staff members forcing Dementia residents to sign documents when they are not cognizant of what they are signing. In addition, interview with the facility Physician revealed that before the resident can start receiving a Hospice or Home Health Services, their Primary Physician has to refer/approve/authorize such services and discuss with the family/resident/resident’s responsible party. Finally, interview with three (3) family members revealed that their loved ones were never forced to sign any documents without their knowledge. Based on the information gathered during the initial visit, this allegation is deemed Unsubstantiated.

Allegation: Unlawful eviction

It was alleged that the facility is placing residents on 51/50 hold and never accepts them back to the facility. During the initial visit, LPA conducted interviews with the Ambassador, Executive Director and Wellness Director and was informed that the facility did not have any incidents with residents being placed on a 51/50 hold in the months of December 2022 through February 2023. Interview with the Ambassador also revealed that the facility will not use that type of absence of a resident from the community as an alternative way to evict the resident. In addition, LPA reviewed all Unusual Incident/Injury Reports submitted to the Regional Office from December 2022 through February 2023 and did not observe any incident with such matter. Based on the information gathered during the initial visit, this allegation is deemed Unsubstantiated.

Allegation: Facility staff inappropriately referring resident(s) to Home Health / Hospice

It was alleged that the residents are forced to sign up with Hospice or Home Health agencies when they do

Continue on LIC9099-C

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Angela Panushkina	TELEPHONE: 747-230-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 31-AS-20230216151130

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: 05/25/2023

NARRATIVE

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not need them. To investigate this allegation LPA conducted interviews (during the initial visit) with the facility Ambassador, two (2) MedTechs, facility Physician, three family members and reviewed facility records. Interview with the Ambassador and two (2) MedTechs revealed that the facility will always provide at least three (3) choices to the residents and their families for Hospice and Home Health services. All staff members denied ever forcing or witnessing other staff members forcing Dementia residents to sign documents when they are not cognizant of what they are signing. In addition, interview with the facility Physician revealed that before the resident can start receiving a Hospice or Home Health Services, their Primary Physician has to refer/approve/authorize such services and discuss with the family/resident/resident’s responsible party. Finally, interview with three (3) family members revealed that their loved ones were never forced to sign any documents without their knowledge. Based on the information gathered during the initial visit, this allegation is deemed Unsubstantiated.

Allegation: Facility has inadequate food supply

Regarding the allegation that the facility has inadequate food supply, LPA conducted interviews with five (5) out of seven (7) residents, who were able to communicate, and was informed by five (5) residents that they believe the facility has enough food supply. LPA observation also revealed that the facility provides complete meal with fruit and vegetable servings on every meal and staff interview revealed that the staff responsible for cooking also customize food being served upon resident's request. Moreover, LPA was informed that the weekly menu may vary and daily menu provides options and alternate option for the residents to choose. Based on the information gathered during the initial visit, this allegation is deemed Unsubstantiated at this time.

Allegation: Facility is mishandling resident(s) monies.

It was alleged that the facility Staff is being directed to use residents’ credit cards without residents’ consent to make purchases. During the initial visit, LPA conducted an interview with the Ambassador, Wellness Director, two (2) staff members, two (2) MedTechs, three (3) family members and five (5) out of seven (7) residents, who were able to communicate. Interviews with the Ambassador, Wellness Director, two (2) staff members and two (2) MedTechs revealed that they don’t have any access to resident’s credit cards and all parties denied ever making any purchase for the residents using residents credit cards. In addition, interview with three (3) family members revealed that the family members are making a purchase on behalf of the resident.

Continue on LIC9099-C

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Angela Panushkina	TELEPHONE: 747-230-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 31-AS-20230216151130

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: 05/25/2023

NARRATIVE

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Finally, interview with five (5) out of seven (7) residents, who were able to communicate, revealed that they are in possession of a credit card/money and it was never used by a facility staff member. Based on the information gathered during the initial visit, this allegation is deemed Unsubstantiated at this time.

Allegation: Facility has no first aid supplies

During the initial visit made on 02/24/23 at 1:45pm, LPA observed three (3) First Aid Kits in MedTechs room. LPA reviewed the facility's first aid kits for completeness. LPA observed the first aid kit complete with the required items as per Title 22 regulations. Therefore, based on LPA’s observation and the information gathered during the initial visit, this allegation is deemed Unsubstantiated at this time.

No deficiencies issued.

Exit interview conducted and copy of this report signed and delivered.

SUPERVISOR'S NAME: Nichelle Gillyard	TELEPHONE: (818) 596-4341
LICENSING EVALUATOR NAME: Angela Panushkina	TELEPHONE: 747-230-3364
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2023

LIC9099 (FAS) - (06/04)

Page: 4 of 4