198320127-8-28-2023-11-AS-MVAO-CXDTNN-20231108135300

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320127
Report Date: 08/28/2023
Date Signed: 08/28/2023 03:28:40 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
08/21/2023 and conducted by Evaluator Antonine Richard

COMPLAINT CONTROL NUMBER: 11-AS-20230821103551

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: 91	DATE:	08/28/2023
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Lilit Mnatsakanyan		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff do not assist resident with bathing.

INVESTIGATION FINDINGS:

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On 08/28/2023, Licensing Program Analyst (LPA) Antonine Richard conducted an unannounced complaint visit. LPA Richard met with Executive Director LiLit Mnatsakanyan. LPA Richard explained the purpose of today's visit. Later LPA was joined with wellness Director Diane Parras.

The investigation consisted of the following: LPA Richard toured the physical plant with Well-Ness Director Parras. LPA toured Resident bedrooms R#1010, R#431, R#514, R#706, R#731, R#1209, and R#1225 and spoke to residents regarding the allegation. LPA Richard obtained copies of Staff and Resident rosters, Resident R1- R7 records (Needs and Service Plan, Pre- Placement Appraisal, Physician Report, Admission Aggreement and Shower Schedules). LPA interviewed residents (R1-R7) about the staff not assiting them with bathing. All residents interviewed, stated they have no issues regrding bathing. Residents (R1-R7) stated they are the ones refusing to take a shower sometimes. LPA interviewed Staff (S1-S6) about the allegation, all staff interviewed stated that they bathe the residents when the schedule says they are required baths.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Antonine Richard	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023

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-20230821103551

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: 08/28/2023

NARRATIVE

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On 08/28/2023, LPA Richard reviewed the shower schedules for the Assisted Living unit it revealed that all the residents that are on the list get their showers as scheduled. Staff also indicated that when resident refuses to be bathed they required to ask three times before they can reschedule them for later that day or the next day. Six out of six staff stated that they provided residents with assistance bathing and grooming.

Based on LPA observations, information gathered, interviews conducted, and records reviews, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is Unsubstantiated.

An exit interview was conducted and a copy of the report was provided to the executive Director Lilit Mnatsakanyan.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Antonine Richard	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 08/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023

LIC9099 (FAS) - (06/04)

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