198320184-4-24-2025-11-AS-UCOL-DGATYV-20250502150918

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320184
Report Date: 04/24/2025
Date Signed: 04/24/2025 09:57:10 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/03/2024 and conducted by Evaluator Mario Leon

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20240903161404

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: 54	DATE:	04/24/2025
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Terri Weitzman, Interim Executive Director		TIME COMPLETED:	10:06 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff do not ensure adequate supervision is provided to residents in care
Staff do not ensure reporting requirements are being followed

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 04/24/25 Licensing Program Analyst (LPA) staff, Mario Leon, conducted a subsequent complaint visit at the facility to provide updated findings of the allegations listed below. This report supersedes the previous report delivered on 01/02/25. The findings for allegation "Staff do not ensure adequate supervision is provided to residents in care" is being changed to Unsubstantiated. LPA was met by Terri Weitzman, Interim Executive Director (S5), and the purpose of the visit was explained.
The investigation consisted of the following:
On 09/11/24 LPA requested six (6) staff records and toured the facility. LPA interviewed four (4) staff (S1-S4) and four (4) residents (R1-R4). On 01/02/25 LPA requested facility records, which included communication records and special incident reports (SIR) from the month of August (dated 08/02/24 through 08/29/24). LPA conducted a tour of the facility and interviewed staff S5 and S6. On 03/06/25 LPA interviewed S5. On 03/13/25 LPA obtained additional facility records. On 03/18/25, LPA interviewed S4. On 03/19/25 LPA toured the facility, requested facility staff and residents’ rosters and interviewed five (5) staff (S2, S4, S7, S8 & S9), three (3) residents (R2, R5 & R6) and interviewed two witnesses (W1 & W2). On 04/21/25 LPA requested four (4) staff training records. Report continues, see LIC9099-C.

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Mario Leon	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025

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 2

Control Number 11-AS-20240903161404

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: AVENIR MEMORY CARE WESTSIDE	FACILITY NUMBER: 198320184
	VISIT DATE: 04/24/2025

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

The investigation revealed the following:
Regarding the allegation "Staff do not ensure adequate supervision is provided to residents in care". It is being alleged that staff did not provide supervision, which resulted in residents being injured by other residents on multiple occasions. Record reviews indicate the following: The facilities’ staff schedule indicates that there are two (2) staff present between the hours of 10:00PM and 06:00AM during the month of August. Staff records indicate that staff are receiving ongoing training's on resident care and supervision. Incident reports from the month of August (dated 08/02/24 through 08/29/24) indicates that only one (1) out of fourteen (14) incidents reported was related to a resident hitting another resident which did not result to an injury.
Interviews revealed that nine (9) out of 9 staff, four (4) out of six (6) residents and two (2) out of 2 witnesses did not agree with the allegation.
Based on record reviews and interviews conducted, 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 that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.

Regarding the allegation “Staff do not ensure reporting requirements are being followed”. It is being alleged that staff do not provide written reports to responsible parties of incidents within seven (7) days. Record reviews indicate the following: Incident reports from the month of August (dated 08/02/24 through 08/29/24) indicates that zero (0) out of fourteen (14) incidents reported was related to resident R1. Facility communication records indicate that the facility was providing updates to residents’ families via electronic messaging.
Interviews revealed that nine (9) out of 9 staff, three (3) out of six (6) residents and two (2) out of 2 witnesses did not agree with the allegation.
Based on record reviews and interviews conducted, 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 that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.

There have been zero (0) deficiencies cited during today’s visit.

An exit interview was held with Terri Weitzman (S5) and a copy of this report has been provided to Terri Weitzman (S5).

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Mario Leon	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 04/24/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/24/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 2