197610191-3-26-2024-31-AS-MVAO-D42UYR-20240405160021

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610191
Report Date: 03/26/2024
Date Signed: 03/26/2024 11:10:54 AM

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
03/20/2024 and conducted by Evaluator Gina Saucedo

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20240320161123

FACILITY NAME:	GARDENS AT NORTHRIDGE, THE		FACILITY NUMBER:	197610191
ADMINISTRATOR:	ANITA CSUKARDI		FACILITY TYPE:	741
ADDRESS:	17650 WEST DEVONSHIRE STREET		TELEPHONE:	(818) 886-1616
CITY:	NORTHRIDGE	STATE: CA	ZIP CODE:	91325
CAPACITY:	135	CENSUS: 87	DATE:	03/26/2024
		UNANNOUNCED	TIME BEGAN:	08:25 AM
MET WITH:	Lisa Villasenor		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Resident's room is not being cleaned
Staff are unable to communicate with residents due to language barrier

INVESTIGATION FINDINGS:

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On 03/26/24, at 8:25am, Licensing Program Analyst (LPA) Gina Saucedo arrived at the facility to conduct an unannounced, initial complaint visit and was greeted by the Executive Director-Lisa Villasenor. LPA disclosed the purpose of the visit. LPA explained the purpose of this visit was to gather information and deliver findings.

On 03/26/2024, at 8:35am, LPA Saucedo asked for the census, resident, and staff roster. The Executive Director-Lisa Villasenor met with LPA Saucedo to conduct the physical tour at 8:45am. During the tour, LPA interviewed eight (08) residents and five (5) staff.

LIC 9099C-continued

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2024

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-20240320161123

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: GARDENS AT NORTHRIDGE, THE	FACILITY NUMBER: 197610191
	VISIT DATE: 03/26/2024

NARRATIVE

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Regarding the allegation: Resident's room is not being cleaned. It is being alleged that RP/Resident #1 (R1) stated their room is not being cleaned. LPA interviewed seven (7) out eight (8) residents that confirmed that their room is cleaned on a weekly basis, and they have no issues with the caregivers or/and housekeepers. LPA interviewed five (5) out of five (5) staff that confirmed they have tried to clean R1's room and R1 does not let them enter their room. LPA was able to confirm that R1 keeps a note on their door by the doorknob that says, "no walk-in maintenance or anyone." LPA was also able to confirm during the physical tour that R1 blocks their door from being opened with the bathroom door and clothing items hanging on a rope. LPA obtained a picture of both the note on the door and the door being blocked from opening. LPA also obtained a note from one of the housekeepers that stated from room 281 not to clean on 03/16/24. Room 281 is a single, room occupied by R1. LPA was able to ask one of the housekeepers to clean R1's room with permission of the executive director; thus, making an exception to clean their room on their non-cleaning day and R1 declined the cleaning services on 03/26/24. Therefore, based on the LPA's interviews, observations, and record reviews the above allegation(s) above is UNSUBSTANTIATED at this time.

Regarding the allegation: Staff are unable to communicate with residents due to language barrier. It is being alleged that the RP/Resident #1 (R1) mentioned that the staff do not speak English, which impedes their ability to communicate with them. LPA interviewed seven (7) out eight (8) residents that confirmed that there is no language barrier with the housekeepers, caregivers, or maintenance. All the staff can communicate with the residents and our able to speak English. LPA also confirmed with R1 if they can speak English and R1 said, “I can speak English and Spanish.” LPA interviewed five (5) out of five (5) staff that confirmed they speak both English and Spanish. The maintenance director also confirmed that they specifically hired one (1) person to enter R1’s room that spoke only English and R1 has now declined to have that person help them. LPA was able to interview the person that got hired specifically to help R1 and they stated, "R1 does not want my services anymore." Therefore, based on the LPA's interviews, observations, and record reviews the above allegation(s) above is UNSUBSTANTIATED at this time.

An exit interview was conducted, no citations were issued for the above allegation(s), and a copy of this report was given to the executive director.

SUPERVISORS NAME: Troy Agard
LICENSING EVALUATOR NAME: Gina Saucedo
LICENSING EVALUATOR SIGNATURE:	DATE: 03/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2024

LIC9099 (FAS) - (06/04)

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