197610366-11-1-2023-31-AS-NMAN-D5KQDZ-20240524120534

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610366
Report Date: 11/01/2023
Date Signed: 11/01/2023 05:11:41 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.ASC, 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
10/17/2023 and conducted by Evaluator Nicholas Reed

COMPLAINT CONTROL NUMBER: 31-AS-20231017115254

FACILITY NAME:	SUMMIT ASSISTED LIVING OF TARZANA		FACILITY NUMBER:	197610366
ADMINISTRATOR:	DAVID AGUINIGA		FACILITY TYPE:	740
ADDRESS:	5711 RESEDA BLVD		TELEPHONE:	(818) 996-2022
CITY:	TARZANA	STATE: CA	ZIP CODE:	91356
CAPACITY:	176	CENSUS: 53	DATE:	11/01/2023
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Jina Maleksarkissians		TIME COMPLETED:	05:15 PM

ALLEGATION(S):

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2
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9

Staff do not ensure residents receive personal mail in a timely manner

INVESTIGATION FINDINGS:

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13

At 8:30 a.m. on 11/01/2023, Licensing Program Analyst (LPA) Nicholas Reed conducted an unannounced subsequent complaint visit. LPA met with staff and later the Executive Director and disclosed the reason for the visit.

Regarding the allegation “Staff do not ensure residents receive personal mail in a timely manner”, it was alleged Resident #1 (R1) did not receive mail the day it was delivered. To investigate the allegation, LPA interviewed six (06) out of fifty three (53) residents and staff between 8:45 a.m. and 2:30 p.m. today. Staff interviews revealed the receptionist sorts the mail on a daily basis and hands the mail to residents or puts the mail in resident mailboxes. Resident interviews revealed no residents experienced issues with receiving mail. Based on interviews, the allegation is deemed UNSUBSTANTIATED at this time.
No immediate health or safety hazards were noted during the time of this visit.
Exit interview conducted. Appeal rights discussed. Copy of report provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Nicholas Reed	TELEPHONE: (818) 669-8178
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2023

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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