198320184-9-6-2023-11-AS-UCOL-CYBR6U-20231208114517

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320184
Report Date: 09/06/2023
Date Signed: 09/06/2023 12:23:20 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
08/22/2023 and conducted by Evaluator Mario Leon

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20230822080312

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:	09/06/2023
		UNANNOUNCED	TIME BEGAN:	08:59 AM
MET WITH:	Jodi Kanowitz, Administrator		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Facility staff not properly trained.

INVESTIGATION FINDINGS:

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On 09/06/23 Licensing Program Analyst (LPA) conducted a subsequent complaint visit to the above mentioned facility to further investigate the above allegations. LPA was met by Jodi Kanowitz, Executive Director (S1), and the purpose of the visit was explained.

The investigation consisted of the following:
On 08/30/23 LPA Leon toured the facility inside and out with Plant Operations staff Robert Garcia (S10), interviewed five (5) staff (S1-S5) and four (4) residents (R1-R4). LPA Leon requested and reviewed facility documents.
On 08/31/23 LPA Leon conducted a subsequent visit and collected additional documents. LPA Leon interviewed facility nurse, Judy Arreaga (S9), via telephone, and further interviewed S1.
On 09/06/23 LPA Leon conducted further record review, took a tour of the first (1st) floor with S10 and reviewed camera footage of the lobby on 08/04/23 from 10:00PM - 06:30AM with S10. LPA Leon interviewed S1, S9 and S10 regarding the camera footage and the staff members observed.
Report Continues, See LIC9099C.

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Mario Leon	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023

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-20230822080312

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: 09/06/2023

NARRATIVE

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The investigation revealed the following:
Regarding the allegation: Facility staff not properly trained.
It has been alleged that the facility staff are not properly trained. On 08/30/23 LPA Leon observed three staff folders and reviewed their training records. LPA Leon interviewed five (5) staff members (S1-S5), all of which have denied the allegation. Additionally, on 09/06/23, LPA Leon requested, and reviewed, the lobby camera footage. Upon which LPA Leon observed zero (0) non-staff individuals attending, or assisting, staff members entering the facility.
According to LPA's observations, interviews and record review conducted, there is not enough evidence to support the above allegation. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the above allegation is Unsubstatiated.

An exit interview was held with Administrator, Jodi Kanowitz (S1), and a copy of this report was provided via email.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Mario Leon	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2023

LIC9099 (FAS) - (06/04)

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