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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610403
Report Date: 02/08/2024
Date Signed: 02/08/2024 02:51:59 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
01/30/2024 and conducted by Evaluator Huma Rahimi
COMPLAINT CONTROL NUMBER: 31-AS-20240130111847
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: 103DATE:
02/08/2024
UNANNOUNCEDTIME BEGAN:
10:40 AM
MET WITH:Adam Syncheff, AdministratorTIME COMPLETED:
03:20 PM
ALLEGATION(S):
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Unlawful eviction
INVESTIGATION FINDINGS:
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On 02/08/2024 at 10:40 am Licensing Program Analyst (LPA) Huma Rahimi conducted an unannounced initial complaint visit to investigate the above stated allegation. LPA met with Executive Director, Adam Syncheff, and explained the reason for the visit.

As part of this investigation, at 11:55 am, LPA conducted a physical plant tour. LPA interviewed with the Executive Director, and three (3) other facility staff members. Additionally, from 12:00 pm to 1:00 PM, LPA interviewed eleven (11) residents in care. At 1:10 pm, LPA also obtained and reviewed copies of pertinent documents relevant to the investigation.

Regarding the allegation: Unlawful eviction. It’s being alleged a facility staff asked R1 to leave the facility and not return. Per interviews and record review, the investigation revealed that the eviction is for a 30-day notice issued on 01/25/2024 for failure to pay.
Continue on LIC 9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Nichelle GillyardTELEPHONE: (818) 596-4370
LICENSING EVALUATOR NAME: Huma RahimiTELEPHONE: (818) 304-2399
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2024
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 2
Control Number 31-AS-20240130111847
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: 02/08/2024
NARRATIVE
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The eviction notice was submitted to R1 and they were advised to vacate within 30 days after being served with the notice. A review of the eviction letter indicates that R1 is late in rent from 12/01/2023 through 01/31/2024 in the amount of $2,767.05, and an additional charge of Room and Board in the amount of $1398.07. LPA observed R1 is still living at the facility, currently, and has not been evicted yet. During an interview with R1 they denied the allegation and stated in summary they were the one who checked themselves into a hotel.

Based on LPA's interviews conducted, record review and observation, the allegation is deemed UNSUBSTANTIATED.

An exit interview was conducted, and a copy of this report was given.
SUPERVISOR'S NAME: Nichelle GillyardTELEPHONE: (818) 596-4370
LICENSING EVALUATOR NAME: Huma RahimiTELEPHONE: (818) 304-2399
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2