198320115-6-21-2024-11-AS-UCOL-D7WPWB-20240807114026

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320115
Report Date: 05/31/2024
Date Signed: 06/21/2024 03:20:01 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 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
05/30/2024 and conducted by Evaluator Socorro Leandro

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20240530141659

FACILITY NAME:	SAWTELLE ONE, LLC		FACILITY NUMBER:	198320115
ADMINISTRATOR:	BRENDA LEDEZMA		FACILITY TYPE:	740
ADDRESS:	4626/4630 SAWTELLE BLVD		TELEPHONE:	(310) 301-8181
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90230
CAPACITY:	6	CENSUS: 2	DATE:	05/31/2024
		UNANNOUNCED	TIME BEGAN:	10:20 AM
MET WITH:	Office Manager - Guadalupe Acosta		TIME COMPLETED:	04:20 PM

ALLEGATION(S):

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Illegal Eviction
Residents personal rights are being violated while in care

INVESTIGATION FINDINGS:

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This is an amendment the purpose of this amendment is to replace the wording “Reporting Party,” “family members” and make the LIC9099 more concise.
On 05/31/2024 at around 10:20 AM Licensing Program Analyst (LPA) Leandro conducted a complaint investigation regarding the allegation listed above. LPA met with the Stella Lewis, Director of Operations and the purpose of the visit was explained.

The investigation consisted of the following:
During today’s investigation LPA and a staff member conducted a tour of the facility.
LPA interviewed 3 out of 11 staff, 2 out of 2 residents, and 2 witnesses. A total of 8 people were interviewed.
LPA received and reviewed Personnel Report, 2 resident’s Physician’s Report for Residential Care Facilities for the Elderly, 1 resident’s Admission Agreement, etc.
LPA requested 2 Admission Agreements, and 2 residents’ 60-day written notice for eviction.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Socorro Leandro	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024

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 11-AS-20240530141659

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: SAWTELLE ONE, LLC	FACILITY NUMBER: 198320115
	VISIT DATE: 05/31/2024

NARRATIVE

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This is an amendment the purpose of this amendment is to replace the wording “Reporting Party,” “family members” and make the LIC9099 more concise.

The investigation revealed the following:

Regarding the allegation “Illegal Eviction,” it is being alleged that licensee has not provided residents with a 60-day written notice for eviction.
Interviews conducted show: 7 out of 8 interviewees indicate that residents have not received a 60-day written notice for eviction.
Record review demonstrates: LPA requested residents’ 60-day written notice for eviction, but facility staff were unable to provide the document to LPA.
Regarding the allegation “Illegal Eviction,” the preponderance of the evidence standard has been met therefore the allegation is substantiated.

Regarding the allegation “Residents personal rights are being violated while in care,” it is being alleged that a licensee representative spoke with a resident and asked if they were ready to vacate the facility by 06/01/2024.
Interviews conducted show:
8 out of 8 interviews conducted indicated that a facility representative informed them and/or residents that the facility will be closing soon and/or by 06/01/2024.
5 out of 8 interviews conducted indicated that the allegation did occur and the licensee representative is causing intimidation for residents in care.
Interviews with residents and witnesses indicated that a facility representative informed them that the facility will be closing by 06/01/2024 and stated “they would like them to go as soon as possible.”
Regarding the allegation “Residents personal rights are being violated while in care,” the preponderance of the evidence standard has been met therefore the allegation is substantiated.

Deficiencies are being cited based on LPA record review and interviews conducted in accordance with the California Code of Regulations, Title 22. An exit interview was conducted, and a copy of this report was left with the Len Judaken, Owner/Licensee along with their appeal rights.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Socorro Leandro	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20240530141659

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: SAWTELLE ONE, LLC	FACILITY NUMBER: 198320115
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/31/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/28/2024 Section Cited CCR 87468.1(a)(3)	1 2 3 4 5 6 7	87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (3) To be free from punishment, humiliation, intimidation, abuse, or other actions of a punitive nature, such as withholding residents’ money or	1 2 3 4 5 6 7	Licensee will treat residents with dignity and respect and have open communications with residents and residents family members. Licensee will retrain staff on personal rights and email proof of correction to Socorro.Leandro@dss.ca.gov and Ulysses.Coronel@dss.ca.gov.
	8 9 10 11 12 13 14	interfering with daily living functions such as eating, sleeping, or elimination. This requirement is not met as evidence by: Based on interviews conducted facility representative directly informing residents that they will have to vacate the facility without providing a 60-day written notice of eviction. Thus, intimidating residents in care.	8 9 10 11 12 13 14
Type B 06/03/2024 Section Cited CCR 87224(a)(5)(A)(1)	1 2 3 4 5 6 7	87224 Eviction Procedures (a) The licensee may evict a resident for one or more of the reasons listed in Section 87224(a)(1) through (5)... (5) Change of use of the facility. (A) The licensee may, upon no less than sixty (60) days written notice, evict a resident due to change of use of the facility. 1. In addition to written notice to quit requirements specified in Section 87224(d), written notice to evict due to change of use of the facility shall be made to the resident or the resident’s responsible person and shall include all requirements specified in Section 1569.682(a)(2)(A) through (F) of the Health and Safety Code.	1 2 3 4 5 6 7	Licensee will provide residents with a 60-day written notice of eviction. Licensee will follow CCLD eviction procedures. Licensee will email proof of correction to Ulysses.Coronel@dss.ca.gov.
	8 9 10 11 12 13 14	This requirement is not met as evidence by: Based on record review and interviews conducted Licensee did not provide residents with a 60-day written notice of eviction.	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Socorro Leandro	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2024

LIC9099 (FAS) - (06/04)

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