198320127-1-18-2023-11-AS-MVAO-CNDRTM-20230124121833

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320127
Report Date: 01/18/2023
Date Signed: 01/18/2023 05:33:53 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 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
01/09/2023 and conducted by Evaluator Jewel Baptiste

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20230109130215

FACILITY NAME:	WATERMARK AT WESTWOOD VILLAGE, THE		FACILITY NUMBER:	198320127
ADMINISTRATOR:	MURPHY, PATRICIA		FACILITY TYPE:	740
ADDRESS:	947 TIVERTON AVENUE		TELEPHONE:	(310) 208-4590
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90024
CAPACITY:	237	CENSUS: 70	DATE:	01/18/2023
		UNANNOUNCED	TIME BEGAN:	10:50 AM
MET WITH:	Administrator Shakeb Rafat		TIME COMPLETED:	03:20 PM

ALLEGATION(S):

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Staff do not safeguard resident's personal property

INVESTIGATION FINDINGS:

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On 1/18/23 at 10:50 a.m., Licensing Program Analyst (LPA) Jewel Baptiste conducted an unannounced complaint visit to the facility. Upon arrival LPA met with Shakeb Rafat (Administrator) and explained the purpose of the visit.

During today’s visit LPA and administrator toured the facility and reviewed the camera footage outside of Resident#1’s apartment. LPA confirmed it is in working condition. LPA obtained resident roster, staff roster, and took pictures of Resident#1’s lock. LPA also interviewed: administrator and a total of two (2) staff who shall be referred to as S1 and S2. LPA interviewed a total of 7 residents who shall be referred to as: R1 through R7. LPA conducted file review for 1 resident.

Report continued con 9099c

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 213-1556
LICENSING EVALUATOR NAME: Jewel Baptiste	TELEPHONE: (323) 400-9594
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2023

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-20230109130215

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: WATERMARK AT WESTWOOD VILLAGE, THE	FACILITY NUMBER: 198320127
	VISIT DATE: 01/18/2023

NARRATIVE

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The investigation reveals the following: Regarding " Staff do not safeguard resident’s personal property.", it is alleged that R1’s clothing, shoes, jewelry, undergarments, and watch has gone missing from their apartment. During the visit LPA toured the facility and observed 1 camera facing R1’s apartment, another camera inside of R1’s apartment and a lock on R1’s closet door. Administrator confirmed R1 has complained about missing items in the past and the facility provided a camera outside of R1’s apartment. The Administrator further stated that the facility reviewed the footage with R1 and did not find anyone entering the apartment. Per administrator resident believes the staff are coming through the closet wall. 2/2 staff interviews confirmed that the facility has always assisted the residents whenever they are missing items and denied staff taking or borrowing items. 6/7 residents confirmed that they do not have problems with missing items and often leaves their doors unlocked. 4/7 residents further stated that 1 resident have complained but believes that the resident has a memory impairment issue because their story does not make sense. 1/7 resident stated staff are borrowing their items and putting it back. The resident further stated they have reviewed the cameras and have not seen anyone entering the apartment and the lock on the closet door can only be opened by the residents in the apartment.

Based on LPA's observation, interviews, and file review the investigation revealed: Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegations are UNSUBSTANTIATED. Exit interview conducted with Shakeb Rafat and a copy of this record provided.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 213-1556
LICENSING EVALUATOR NAME: Jewel Baptiste	TELEPHONE: (323) 400-9594
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2023

LIC9099 (FAS) - (06/04)

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