198320184-9-14-2023-11-AS-EMAZ-CXSTVN-20231121140412

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320184
Report Date: 09/14/2023
Date Signed: 09/14/2023 01:52:37 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
08/28/2023 and conducted by Evaluator Alfonso Iniguez

COMPLAINT CONTROL NUMBER: 11-AS-20230828150708

FACILITY NAME:	AVENIR MEMORY CARE WESTSIDE		FACILITY NUMBER:	198320184
ADMINISTRATOR:	JODI KANOWITZ		FACILITY TYPE:	740
ADDRESS:	7501 OSAGE AVE		TELEPHONE:	(424) 282-0040
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90045
CAPACITY:	88	CENSUS: 40	DATE:	09/14/2023
		UNANNOUNCED	TIME BEGAN:	09:21 AM
MET WITH:	Jody Kenowitz/Executive Director		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Licensee does not ensure staff have the ability to communicate with residents

INVESTIGATION FINDINGS:

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On 9/14/2023 LPA Alfonso Iniguez conducted and unannounced complaint visit. LPA Iniguez meet with Jodi Kanowitz/Executive Director. LPA explained the purpose of this visit.

Investigation Consisted of: LPA conducted Resident’s interviews (R#1-R#4) and did a physical tour of the facility. LPA obtained and reviewed the following documents: Resident’s roster, Personnel roster, (R#1-R#4) Identification and Emergency Information, (R#1-R#4) Admissions agreements, (R#1-R#4) Physicians Report for Residential Care Facilities for the Elderly, (R#1-R#4) Needs and Services Plan, (R#1-R#4) Medication Administration Record (MAR) for the month of August 2023, (S#1-S#4) Admissions Agreement, Staff Relias Training from April to September 2023 and LIC 501.

Evaluation Report continues LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

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 3

Control Number 11-AS-20230828150708

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: AVENIR MEMORY CARE WESTSIDE	FACILITY NUMBER: 198320184
	VISIT DATE: 09/14/2023

NARRATIVE

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Investigation Revealed the Following:

Allegation: Licensee does not ensure staff have the ability to communicate with residents

The details of the complaint alleged that the facility staff is not able to communicate with residents.

During the records review, LPA Iniguez reviewed (R#1-R#4) the Admissions Agreement. Under the Statement of Resident’s Personal Rights, section 87468.2(a)(1) says: In addition to the rights listed in section 87468.2, Personal Rights of Residents in All facilities, residents in privately operated residential care facilities for the elderly shall have of the following rights: To have a reasonable level of personal privacy in accommodations, medical treatment, personal care, and assistance, visits, communications[...]

Also, LPA reviewed (R#1) and all the facility staff their Relias training; these were the topics the staff already took: Communication and People with Dementia, Communication, and the Hearing impaired, Communication: Courtesy, Communication: Patronizing Language, Effective Communication Skills, Knowing the Rights of Residents and Personal Rights and Ethics. A total of 5 hours of training was used to cover these topics.

In addition, LPA reviewed the overview of trainings for all staff, 19 out of 22 has 0 trainings due within 30 days, 0 due within 90 days and 0 due within 7 days, only 3 staff members have overdue trainings. Administration has a plan in place for the staff that has an overdue training on Relias. Staff will take trainings before they start their shift on 9/14/2023.

During an Interview with the Executive Director (A#1), she stated that the staff takes training on Relias before they get hired in the facility; plus, we do cross-over meetings every day and once a month for staff training, and the training is assigned in the Relias portal. On the other side, the Executive Director stated that all staff can communicate with the residents; every day, the staff reviews the resident's care plan, and the nurse communicates with the team regarding each resident. This way, the staff has a plan to address their needs. In addition, the Executive Director stated that all staff could communicate with the residents, but if a staff cannot do it, they can reach out to me or the nurse; we are available 24/7. The executive director stated that (S#1) can communicate with them; (S#1) participates in the staff meetings, and they can speak about their residents and their needs. (A#1) acknowledges (S#1) first language is not English, but they assure (S#1) can understand what the residents need.

Evaluation Report continues LIC 9099-C

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20230828150708

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: AVENIR MEMORY CARE WESTSIDE	FACILITY NUMBER: 198320184
	VISIT DATE: 09/14/2023

NARRATIVE

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During an interview with (S#1), LPA asked S#1 questions regarding how often they take training. S#1 stated that every month, but LPA noticed (S#1) could not understand the question, LPA had to repeat it four times. In addition, LPA started to see that S#1 did not understand the context of the questions; LPA tried to dissect the questions, but still, (S#1) could not answer the questions. At this moment, LPA had to finish the interview and document the event.

During interviews with staff (S#2-S#4), 3 out of 3 stated that they take their training on Relias. Relias has training modules with an expiration date. In addition, 3 out of 3 can communicate with the residents and need help understanding what the residents say to them. On the other hand, 2 out of 3 staff stated that S#1 has a language barrier that prevents them from communicating with the residents properly.

During interviews with residents (R#1-R#4), 4 out of 4 stated that the staff helps them with their basic needs and can communicate with the staff. Also, 4 out of 4 stated that they do not have problems understanding what the staff is telling them, and they do not know a staff member who cannot communicate with them.

During this investigation, LPA found did not find sufficient evident to support the above-mentioned allegation(s).

Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegation is found to be UNSUBSTANTIATED.

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.

California Code of Regulations (Title 22, Division 6, Chapter 8).

An exit interview was conducted, and a copy of the Complaint Report was given to Jody Kanowitz/Executive Director.

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

LIC9099 (FAS) - (06/04)

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