198320184-12-7-2023-11-AS-RORN-D2PUDU-20240222143008

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320184
Report Date: 12/05/2023
Date Signed: 12/07/2023 12:14:37 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO 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
11/27/2023 and conducted by Evaluator Pamela Bunker

COMPLAINT CONTROL NUMBER: 11-AS-20231127130211

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: 48	DATE:	12/05/2023
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Ashley Shire and Robert Garcia, Jr.		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Staff do not address the issues with the facility's emergency exit

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint visit on Tuesday, December 05, 2023, Upon arrival at the facility. LPA Bunker called the facility via telephone and conducted a Risk Assessment. Based on the assessment, the facility is cleared of COVID-19 infection. LPA Bunker met with Director of Sales and Marketing Ashely Shire and Director of Plant Operations Robert Garcia, Jr. LPA Bunker explained the purpose of today's visit.
The investigation consisted of the following: Involving interviews with both staff members (S1-S2) and residents (R1-R5). LPA Bunker spearheaded the inquiry, asking pertinent questions that aligned with the nature of the complaint. A critical aspect of the investigation included a thorough examination of the emergency exit door and the adjacent passenger elevator on the first and second floors. Our observations confirmed that staff member S1 successfully operated the emergency door in the elevator lobby using a passcode. The staff has multiple secure access options, including a fob, key card, or passcode, to enter the community areas. Significantly, both the emergency exit doors and elevators were found to be free from substantial risk, ensuring the safety and well-being of staff, visitors, and residents. The operational integrity of the emergency exit door, particularly from the lobby to the elevator, was verified, confirming its excellent working condition. See continued LIC9099-C page 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Pamela Bunker	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2023

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-20231127130211

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: AVENIR MEMORY CARE WESTSIDE	FACILITY NUMBER: 198320184
	VISIT DATE: 12/05/2023

NARRATIVE

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Continued LIC9099-C page 2

LPA Bunker requested copies of supporting documents

Allegation: Staff did not address the issues with the facility's emergency exit. In response to this, allegation interviews were conducted with both staff members (S1-S2) and residents (R1-R5). The collective feedback from these interviews unanimously indicated no issues concerning the facility's emergency exit doors. An inspection conducted during our visit affirmed that the lobby emergency exit door and the passenger elevator were fully operational and maintained in optimal working condition. Residents (R1-R5) expressed their satisfaction with living at the facility, highlighting the respect, dignity, and quality of care they receive. They also commended the facility for providing a secure, healthful, and comfortable living environment. Both staff (S1-S2) and residents (R1-R5) refuted the allegation, reinforcing the commitment to safety and well-being upheld at the facility.

Investigation revealed the following: The inquiry involved detailed interviews with staff members (S1-S2) and residents (R1-R5). It was established that the facility, constructed in 2021, features relatively new emergency exit doors and elevators. The City of Los Angeles Department of Building and Safety conducted an inspection on 11/27/2023, specifically targeting the Hydro Electric Elevator. The facility holds a valid Certificate of Inspection and a Permit to Operate an Elevator (Permit ID: Q4269914, Elevator Number: 00188249), prominently displayed within the elevator car. Regular servicing of the elevator is conducted to ensure optimal functionality. In emergencies, staff at the Receptionist's desk can swiftly activate all emergency exit doors in under 30 seconds. Access mechanisms include a key card, fob, or passcode. Visitor key cards, time-limited for access, facilitate entry through emergency doors and passenger elevators to specific floors during business hours. The emergency exit doors feature a security protocol that includes a delay mechanism, audible alerts, and an automatic alarm system in case of prolonged open status. These doors are also equipped with a manual push bar for immediate egress in urgent situations, ensuring an effective delayed egress during emergencies. After thorough interviews, observation, and review of all pertinent records and evidence, it was concluded that there is insufficient evidence to substantiate the allegation. Despite the possibility of the incident occurring, the lack of a preponderance of evidence to confirm the alleged violation leads to the determination that the allegation is unsubstantiated.
A copy of the Complaint Investigation Report LIC9099, and LIC9099-C, was provided to staff. There were no deficiencies cited. Exit interview conducted.

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Pamela Bunker	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 12/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2023

LIC9099 (FAS) - (06/04)

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