197610032-11-21-2023-31-AS-MVAO-CYVUED-20231226143058

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610032
Report Date: 11/21/2023
Date Signed: 11/21/2023 04:18:32 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 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
11/15/2023 and conducted by Evaluator Evelin Rios

COMPLAINT CONTROL NUMBER: 31-AS-20231115140007

FACILITY NAME:	LEISURE GARDEN SENIOR ASSISTED LIVING FACILITY		FACILITY NUMBER:	197610032
ADMINISTRATOR:	JESSICA PELAYA		FACILITY TYPE:	740
ADDRESS:	44523 15TH STREET WEST		TELEPHONE:	(661) 941-4578
CITY:	LANCASTER	STATE: CA	ZIP CODE:	93534
CAPACITY:	157	CENSUS: 125	DATE:	11/21/2023
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Jessica Pelaya		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff does not allow resident to have visitors.
Staff are listening in on resident's private phone conversations.

INVESTIGATION FINDINGS:

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On 11/21/2023 Licensing Program Analyst (LPA) Evelin Rios conducted an unannounced complaint visit for the above allegations. LPA arrived at 1:30 p.m. and was greeted by Administrator, Jessica Pelaya. LPA explained to Jessica the reason for the visit. An entrance interview was conducted.

At 1:50 p.m. LPA conducted a physical plant tour of the facility with Jessica. LPA requested copies of the facility resident roster and staff roster. At approximately 2:00 p.m. LPA interviewed resident #1 (R1), the resident mentioned in this complaint and randomly selected six (6) other residents to interview. LPA also interviewed staff #1 (S1) at reception responsible for answering calls and dialing phone numbers for residents on the community telephones. At 2:26 p.m. LPA observed a family member in the lobby requesting to visit with a resident at this facility. LPA observed S1 at reception take the family member into the facility for a visit. Receptionist returned to the lobby a little while later. LPA confirmed with receptionist they walked the family member to where the resident was.
(Cont. to LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Evelin Rios	TELEPHONE: 424-299-6104
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

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-20231115140007

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
N LA & CEN COA AC/SC, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: LEISURE GARDEN SENIOR ASSISTED LIVING FACILITY	FACILITY NUMBER: 197610032
	VISIT DATE: 11/21/2023

NARRATIVE

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(Cont. from LIC9099)
Allegation #1: Staff does not allow resident to have visitors. It is alleged the facility has allowed R1's family member, to determine who visits or gets information about R1. To investigate the allegation LPA interviewed R1. Interview with R1 revealed they are allowed visitors. When LPA asked if the facility had ever denied them a visitor, R1 responded, they didn't know anything about that. LPA's interview with Jessica revealed R1 is not conserved and due to resident's rights family members would not be able to request the facility to keep visitors from meeting with resident unless the resident makes such request. LPA reviewed R1's admission agreement, visitor's policy section. According to Jessica due to HIPPA laws facility is not allowed to share personal information about a resident to individuals in the public requesting personal information about the resident unless the resident gives facility permission to do so. Interviews with residents revealed they are allowed visitors and the facility has not denied them visitors. Based on interviews and LPA's observation this allegation is deemed Unsubstantiated at this time.

Allegation #2: Staff are listening in on resident's private phone conversations. It is alleged staff listen in on R1's phone calls. To investigate the allegation LPA interviewed R1. Interview with R1 revealed they take personal calls on the community telephone. According to R1 they can take and make calls to whoever they want. When LPA asked if R1 has ever not answered a personal call or has hung up a telephone call R1 requested LPA to stop prying into their personal business. R1 went on to confirm they are comfortable taking calls here. When LPA asked R1, if they ever felt facility staff eavesdropped on their telephone conversations, R1 responded no. LPA interviews with various residents revealed if they use the community telephone they feel like they have privacy and they don't think staff are eavesdropping on their telephone conversations. Based on interviews this allegation is deemed Unsubstantiated at this time.

Exit interview conducted. No deficiencies were cited. A copy of the report was provided.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Evelin Rios	TELEPHONE: 424-299-6104
LICENSING EVALUATOR SIGNATURE:	DATE: 11/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2023

LIC9099 (FAS) - (06/04)

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