198320184-11-2-2022-11-AS-MVAO-CQLPJL-20230405112140

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320184
Report Date: 11/02/2022
Date Signed: 11/02/2022 03:17:31 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
10/26/2022 and conducted by Evaluator Martessa Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20221026153105

FACILITY NAME:	AVENIR MEMORY CARE WESTSIDE		FACILITY NUMBER:	198320184
ADMINISTRATOR:	DRINKHOUSE-QUINTA, MARISSA		FACILITY TYPE:	740
ADDRESS:	7501 OSAGE AVE		TELEPHONE:	(424) 282-0040
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90045
CAPACITY:	88	CENSUS: 24	DATE:	11/02/2022
		UNANNOUNCED	TIME BEGAN:	10:25 AM
MET WITH:	Jodi Kanowitz-Administrator		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Allegation: Facility not maintained in good repair.

INVESTIGATION FINDINGS:

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

On 11/2/22, Licensing Program Analyst (LPA) Martessa Brown initiated a 10-day complaint visit at the above facility. Before entering in the building, LPA called the facility to conduct a risk assessment. LPA spoke with Administrator Jodi Kanowitz who confirmed the facility is Covid-19 free. LPA was greeted by Administrator and explained the purpose of today's visit.

The investigation consisted of the following: LPA toured the entire facilities 1st, 2nd fl and outside areas of the facility. LPA requested and obtained Resident and Staff Rosters. LPA interviewed Administrator(S1), staff members (S2-S4) and attempted to interview residents (R1-R4).
Investigation consisted of the following.

Allegation: Facility not maintained in good repair.

LiC 9099i-C s on the next page.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Martessa Brown	TELEPHONE: (714) 743-4597
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022

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-20221026153105

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: 11/02/2022

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

It is alleged that facility has a fence that is tied up and surrounds the facility. On 11/2/22 LPA conducted interviews with Administrator and staff members S2-S4. Administrator and staff stated the fences have been there since they all have been working in the facility. Staff stated the gate were put there for prevention methods due to homeless people entering from outside of the building. Staff stated the homeless people would walk onto the property and feces would be found on side of building. Staff S2 stated there would also be drug related items located on the grounds. LPA observed 2 fences on both sides of the building. One of the fences located towards the back of building was tied on one side to hold the gate up. LPA was able to move both gates forward and backwards and did not see any fire hazards. LPA observed the facility to be locked and secured on the inside with alarms systems. Based on LPAs observations and interviews conducted the above allegation is unsubstantiated.

Based on the department’s investigations, there is no sufficient evidence to support the allegation, Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED.

No deficiencies were cited during this visit.

Exit interview conducted and a copy of this report was provided to Administrator Jodi Kanowitz.

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Martessa Brown	TELEPHONE: (714) 743-4597
LICENSING EVALUATOR SIGNATURE:	DATE: 11/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 2