197610403-9-6-2024-31-AS-NMAN-D8ZUE8-20240911153042

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197610403
Report Date: 09/06/2024
Date Signed: 09/06/2024 01:33:54 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
10/18/2023 and conducted by Evaluator Antonia Alvizar-Ettima

PUBLIC

COMPLAINT CONTROL NUMBER: 31-AS-20231018121826

FACILITY NAME:	GARDEN OF PALMS LA		FACILITY NUMBER:	197610403
ADMINISTRATOR:	HIRSCH,RENA		FACILITY TYPE:	740
ADDRESS:	1025 N FAIRFAX AVE		TELEPHONE:	(323) 656-7900
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90046
CAPACITY:	130	CENSUS: 104	DATE:	09/06/2024
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Executive Director, Adam Syncheff		TIME COMPLETED:	01:20 PM

ALLEGATION(S):

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Staff is unlawfully evicting a resident while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst LPA Antonia Alvizar-Ettima conducted a subsequent complaint visit to deliver final findings of the investigation of the above allegation. LPA met with Executive Director and explained the reason for the visit.

It was reported that the resident #1 (R1) received 30-day eviction notice due to default of payment. R1’s responsible party was unable to pay rent due to pandemic. The checks provided to the facility were bounced and the owner was refusing to take partial payment.

Initial investigation was conducted on 10/27/2023 by LPA Antonia Alvizar and LPM Naira Margaryan. During initial visit at 7:30am, LPM spoke with the Executive Director (ED) Rena Hirsch. At 10:30 a.m. LPA Alvizar-Ettima requested copies of the facility documents including, but not limited to staff and resident roster, resident #1 (R1’s) physician report, needs and service plan, admission agreement and other pertinent documents relevant to the investigation.

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: 09/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024

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-20231018121826

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 LA	FACILITY NUMBER: 197610403
	VISIT DATE: 09/06/2024

NARRATIVE

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Between 10:45 a.m. and 1:00 p.m. LPA and Executive Director toured the physical plant. On or around 2:48 p.m. LPA spoke with facility owner, Adam Zenou via phone and asked questions relevant to the nature of the complaint.

Prior to this visit LPA Alvizar-Ettima reviewed records previously received from ED.

ED and the owner indicated that they had no intention to evict R1. Per ED R1 is residing in the facility on 05/22/2019. Since admission R1’s responsible party was either paying partial payment or was not paying at all. ED was trying to communicate with R1’s responsible party and they were not responding. On 11/10/2022 R1 and their responsible party were notified in writing that either R1’s responsible party would pay a 50% of default payments or they will proceed with eviction procedures. On 12/10/2022 R1’s responsible party paid back due payments until November 2022 and requested a new 30-day eviction notice and a copy of the bill to apply for rental assistance for R1. On 12/14/2022 ED e-mailed a new copy of eviction notice to R1’s responsible party, so that they could apply for rental assistance. A review of facility records conducted on 05/17/2024 at 4:00pm, verified the information provided by ED. At the time of this visit LPA was informed that R1 moved out of the facility on 11/10/2023.

Based on the interviews, and record review, there is no sufficient 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.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Antonia Alvizar-Ettima	TELEPHONE: (818) 383-6108
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024

LIC9099 (FAS) - (06/04)

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