197610366-5-3-2023-31-AS-TAGD-CVLV7W-20230912161150

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610366
Report Date: 05/03/2023
Date Signed: 05/03/2023 02:30:19 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
04/25/2023 and conducted by Evaluator Tuesday Cabiness

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20230425103258

FACILITY NAME:	SUMMIT ASSISTED LIVING OF TARZANA		FACILITY NUMBER:	197610366
ADMINISTRATOR:	NIRJARA ACHARYA		FACILITY TYPE:	740
ADDRESS:	5711 RESEDA BLVD		TELEPHONE:	(818) 996-2022
CITY:	TARZANA	STATE: CA	ZIP CODE:	91356
CAPACITY:	176	CENSUS: 33	DATE:	05/03/2023
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Nirjara Acharya		TIME COMPLETED:	02:40 PM

ALLEGATION(S):

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1. Facility in disrepair
2. Staff not providing adequate housekeeping services to residents in care
3. Facility has vermin
4. Residents are not being provided adequate food services

INVESTIGATION FINDINGS:

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Licensing Program Analyst LPA) Tuesday Cabiness conducted an initial visit to investigate the allegations mentioned above. LPA met with Executive Director Nirjara Acharya and informed her the reason of the visit. The following was determined:

Allegation # 1: Concerns were expressed that facility is in disrepair; with no hot water, and roaches. During today's visit, from 12pm to 240pm, LPA conducted a physical plant inspection in the kitchen area, and resident's rooms. LPA also conducted interviews with residents and staff. It was reported that the facility had no hot water. LPA randomly measured resident's rooms, and hot water was measured from 105.8 to 110.7. During interviews, it was reported that there was an issue with roaches with the previous owners; but the issue has been resolved and the ED reported that the facility has hired a monthly pest control service to treat the facility. Also, LPA did not observe any roaches during today's inspection in resident's rooms or kitchen area. Also resident's have not reported to the ED that there are roaches. Therefore, the allegation is UNSUBSTANTIATED at this time.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Tuesday Cabiness	TELEPHONE: (818) 299-4975
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

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-20230425103258

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: SUMMIT ASSISTED LIVING OF TARZANA	FACILITY NUMBER: 197610366
	VISIT DATE: 05/03/2023

NARRATIVE

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Allegation # 2: Concerns were expressed that staff are not providing adequate housekeeping services to residents in care. During today's visit, from 12pm to 240pm, LPA conducted interviews with staff and residents. It was reported to LPA, that not all resident's rooms are being cleaned the same day. The ED reported to LPA, that the previous housekeeper was not rehired during the transition of new ownership and they recently hired new housekeepers. During today's visit, LPA observed a housekeeper cleaning various resident's rooms. Resident's reported, they would like to have there rooms cleaned more often; but there rooms are being cleaned. The ED also has hired an additional laundry staff to assist with housekeeping services. Therefore, based on interviews, the allegation is UNSUBSTANTIATED.

Allegation # 3: Concerns were expressed the facility has vermin. During today's visit, from 12pm to 240pm, LPA conducted interviews with staff and residents; as well as a physical plant inspection. It was reported the facility has vermin. During today's visit neither staff or residents have observed any rodents at the facility. LPA conducted a physical plant inspection in the kitchen area, and resident's rooms, and there was no signs of any rodent feces or droppings. The Executive Director reported to LPA, the facility has a monthly pest control service to treat any issues at the facility. There has been no treatment of vermin. Therefore, based on interviews and physical plant inspection, the allegation is UNSUBSTANTIATED at this time.

Allegation # 4: Concerns were expressed residents are not being provided adequate food services. During today's visit from 12pm to 240pm, LPA conducted a physical plant inspection, and interviewed staff and residents. It was reported to LPA, that the previous owners did not provide adequate food, and the facility did not have vendors to provide healthy and nutritional food. Resident's reported to LPA, the food was distasteful and not good. The current ownership has vendors in place and have delivered fresh non-perishable and perishables to the facility. During the kitchen inspection, LPA checked the freezer and refrigerator, and observed quality and fresh food for the residents; as well as observed the daily menu. Resident's also reported to LPA, the food has become much healthier and better quality. Therefore, based on physical plant inspection and interviews, the allegation is UNSUBSTANTIATED at this time.

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Tuesday Cabiness	TELEPHONE: (818) 299-4975
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

LIC9099 (FAS) - (06/04)

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