198201496-6-1-2020-11-AS-JHAD-BR6VM2-20200703163249

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198201496
Report Date: 05/27/2020
Date Signed: 06/01/2020 02:15:05 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/13/2020 and conducted by Evaluator Ana Soto

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20200513110953

FACILITY NAME:	BEVERLY HILLS GARDENS CARE CENTER		FACILITY NUMBER:	198201496
ADMINISTRATOR:	JOHN STIENFIELD		FACILITY TYPE:	740
ADDRESS:	1470 S. ROBERTSON BLVD		TELEPHONE:	(310) 273-3668
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90035
CAPACITY:	110	CENSUS: 85	DATE:	05/27/2020
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Ella Naygas, Administrator		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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Facility staff do not keep facility clean

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ana Soto conducted subsequent complaint tele-visit to provide findings and decision for the allegation listed above . Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s subsequent visit was conducted telephonically with Ella Naygas, facility administrator.

Based on the LPA's investigation, the investigation revealed the following: Facility staff do not keep facility clean. LPA Soto on 05/21/20 @ around 11:00am interviewed administrator, Ella Naygas, Assistant Administrator Clifford Johnson, and Clients #1 - #9, they all stated that the facility is always clean. The clients rooms and restrooms, common areas such as: rest rooms, tv room, living room, dining room, and etc. are clean and well maintained. LPA Soto @ around 11:30am on 05/21/20, inspected the entire facility (clients rooms, patio, rest rooms, living room, dining room, kitchen, storage area, and administrator office.)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ana Soto	TELEPHONE: (323) 383-8284
LICENSING EVALUATOR SIGNATURE:	DATE: 05/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2020

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 11-AS-20200513110953

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BEVERLY HILLS GARDENS CARE CENTER	FACILITY NUMBER: 198201496
	VISIT DATE: 05/27/2020

NARRATIVE

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The facility is well kept, per the house keeping schedule, house keepers clean the entire facility 1x a day, 3x a week. The walls and floors were clean and mopped, LPA Soto did not see any area of the facility that was not well maintained. Based on the Department’s investigation, the evidence did not support the above allegation.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the above violation did or did not occur, therefore the allegation is unsubstantiated.

No Deficiencies cited.

A telephonic exit interview was conducted with Ella Naygas, Administrator, and a hard copy was provided via email for signature.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ana Soto	TELEPHONE: (323) 383-8284
LICENSING EVALUATOR SIGNATURE:	DATE: 05/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/27/2020

LIC9099 (FAS) - (06/04)

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