<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610403
Report Date: 07/30/2024
Date Signed: 07/30/2024 02:45:33 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
07/23/2024 and conducted by Evaluator Raymond Comer
COMPLAINT CONTROL NUMBER: 31-AS-20240723125344
FACILITY NAME:GARDEN OF PALMS LAFACILITY NUMBER:
197610403
ADMINISTRATOR:HIRSCH,RENAFACILITY TYPE:
740
ADDRESS:1025 N FAIRFAX AVETELEPHONE:
(323) 656-7900
CITY:LOS ANGELESSTATE: CAZIP CODE:
90046
CAPACITY:130CENSUS: 107DATE:
07/30/2024
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Administrator-Adam SyncheffTIME COMPLETED:
03:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not accurately manage resident’s medications.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
At 10:00AM, on Tuesday, 7/30/24, Licensing Program Analyst, (LPA) Raymond Comer, arrived to the facility to conduct an unannounced complaint visit and investigate the above allegation. LPA met with administrator, Adam Syncheff, and disclosed the reason for the visit.

Allegation: Staff do not accurately manage resident’s medications-

Is is alleged that Staff do not track, nor record Residents' expired medications. To investigate the allegation, on 07/30/2024, LPA, Raymond Comer, conducted an observation of the medication room and mobile medication carts from 10:35 AM to 11:25AM, completed interviews with two (2) Med-Tech Staff employees from 11:30 AM to to 12:30 PM, and requested documents at 12:45 PM. LPA observed the medication room as locked and inaccessible to Residents.

[LIC 9099C- Continued]
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 31-AS-20240723125344
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: 07/30/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Upon entry, LPA observed the medication room as clean and organized as purposed. A camera is installed to video record Staff activities. All Resident medications were observed as secured in locked cabinets; no medications were observed as loose and/or outside secured containment. LPA, with the assistance of the Staff Wellness Director (S1) and Staff Wellness Coordinator (S2) conducted an audit of the medications for sixteen (16) Residents. A comparison of each Resident's medication control log with their corresponding medications resulted in LPA finding no discrepancies. LPA gathered Medication Destruction Records, reviewed the facility's Medication Destruction Records Log finding no discrepancies. All expired medications, used syringes, and all other pharmaceutical waste is placed in a closed container and scheduled for bio-hazard disposal by vendor. (Market Rx)
LPA interviewed S1 and S2 who stated all expired medications are tracked, recorded and scheduled for picked up by bio-waste management vendor for destruction. Staff confirms all medications are logged, dispensed to Residents, and expired medications destroyed as per facility policy and Tittle 22 regulations.

Based on LPA observation, file review, and interviews, the allegation is UNSUBSTANTIATED at this time.

No deficiency cited. Exit interview conducted. Copy of this report issued.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3