197609826-8-9-2024-31-AS-NMAN-D8XMBK-20240909092800

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609826
Report Date: 08/09/2024
Date Signed: 08/09/2024 02:18:20 PM

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
07/20/2023 and conducted by Evaluator Antonia Alvizar-Ettima

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20230720112744

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:	0	CENSUS: 105	DATE:	08/09/2024
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:			TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff inappropriately handle residents in care.
Staff forcing residents to take showers.
Resident sustained unexplained injuries while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Antonia Alvizar conducted unannounced subsequent complaint visit to the facility to continue investigation of the above noted allegations and to deliver final report. At 10:20am. LPA met with the Wellness Assistant, Karla Garcia.

On 07/21/23 LPA Laqueena Lacy conducted an initial visit at which time at 11:05am, LPA requested and obtained copies of facility files and documents including but not limited to the staff and resident rosters, physician report and shower schedule. Between 11:10am -12:11am, LPA Lacy interviewed Administrator, staff, and residents. At the time of this visit at approximately 1:10pm. LPA Alvizar spoke with eight (8) additional residents and facility staff present during this visit. LPA and Wellness assistant conducted a physical plant tour.

Staff inappropriately handle residents in care.
It was reported staff has twisted resident #1 (R1’s) arm, tipped their chair.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima	TELEPHONE: (818) 383-6108
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2024

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-20230720112744

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: GARDEN OF PALMS	FACILITY NUMBER: 197609826
	VISIT DATE: 08/09/2024

NARRATIVE

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Staff denied twisting R1’s arm. They indicated that R1 was did not require an assistance with ADL. Staff did not hand on contact with R1. They were only providing medication assistance.
Residents interviewed during this investigation did not address any concerns about Staffs assistance.
A review of facility records conducted on 09/14/23 verified information revealed by facility staff.

Based on interviews and record review there is no pertinent information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

Staff forcing residents to take showers.
Concerns were addressed that staff was forcing R1 to take showers. Staff denied forcing residents to take a shower. They revealed that R1 was able to take a shower/bathe themself. Other residents interviewed during investigation denied being forced to take a shower. Records verify that R1 is able bathe/shower themselves. Per review of R1’s shower schedule, R1 was taking showers 2-3 time per week and the staff was keeping shower schedule for R1.

Based on observation, interviews, and record review there is no sufficient information to corroborate the allegation. Therefore, allegation deemed to be UNSUBSTANTIATED at this time.

Resident sustained unexplained injuries while in care.

It was reported that the facility resident #4 (R4), was observed with bruises on their face.
During facility inspection conducted on 07/21/23 and at the time of this visit at (time), LPAs observed residents in the lobby, dining area, other common areas and did not observe any resident with bruises. Staff denied seeing bruises on R2’s face. Residents interviewed during investigation denied having bruises on their face. R2, who at times was making loud voices, had no bruises on their face.

Based on observation and interviews there is no supporting information to verify the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

No immediate health and safety hazard is noted during this visit.
Exit interview was conducted, and a copy of report was issued to Wellness Assistant.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima	TELEPHONE: (818) 383-6108
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2024

LIC9099 (FAS) - (06/04)

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