198320197-8-9-2023-11-AS-EMAZ-CUQTTG-20230815150044

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320197
Report Date: 08/09/2023
Date Signed: 08/09/2023 01:12:58 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
01/23/2023 and conducted by Evaluator Elizabeth Ceniceros

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20230123150309

FACILITY NAME:	PLAZA AT WESTWOOD, THE		FACILITY NUMBER:	198320197
ADMINISTRATOR:	KELLEY KOUL		FACILITY TYPE:	740
ADDRESS:	2228 WESTWOOD BLVD		TELEPHONE:	(323) 217-7877
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90064
CAPACITY:	136	CENSUS: 64	DATE:	08/09/2023
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Staff #1 (Theresa Pascual, Wellness Director)		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff do not treat resident with respect.
Staff do not meet dietary needs of resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA)/Retired Annuitant (RA) Elizabeth Ceniceros made an unannounced visit to the facility and was greeted by Staff #1 (Theresa Pascual, Wellness Director) and was later met by Administrator (A1: Virginia Zenteno). RA conducted a risk assessment prior to entering facility. S1 informed RA that the facility has no COVID cases nor do residents or staff have symptoms. The purpose for today’s visit is to conduct a subsequent visit and to deliver the findings pertaining to the above-mentioned allegation(s).

An initial 10-Day visit was conducted by LPA Martessa Brown on 01/26/23 who was met by Staff #1 (S1: Theresa Pascual, Wellness Director) as the Administrator (Virginia Zenteno) was unavailable at that time. During RA Ceniceros subsequent visit, RA interviewed Administrator, Staff #2 (Caregiver), Staff #3 (Caregiver), Staff #4 (Head Cook); and, re-interviewed Staff #1 (Wellness Director), Residents #1 (R1), #2 (R2), #3 (R3), #4 (R4), #6 (R6), . RA did not interview Resident #5 (R5) or Resident #7 (R7) as they no longer reside at the facility. RA toured the facility’s commercial-size kitchen for health and safety purposes and observed a posted special diet menu (photo) and residents at mealtime (breakfast).

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Elizabeth Ceniceros	TELEPHONE: (916) 224-1579
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2023

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-20230123150309

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: PLAZA AT WESTWOOD, THE	FACILITY NUMBER: 198320197
	VISIT DATE: 08/09/2023

NARRATIVE

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RA reviewed the following documents: staff and resident rosters, admissions agreement, appraisal/needs and services plan, physician’s report, posted special diet notes, 6-week regular menu prepared by their Dietician, and staff training record on the topic of Personal Rights conducted on 08/15/22.

Regarding Allegation #1: this investigation revealed based on interviews conducted of eight (8) residents (R1 – R8), 3 of the 8 residents corroborated that Administrator does not display a professional attitude towards the residents and is very rude; and, 5 of the 8 residents corroborated that they did not have any issue or concern with the Administrator’s behavior or attitude of being rude or disrespectful towards a resident nor observed the Administrator to be verbally abusive towards a resident. Interviews conducted of five (5) facility staff (S1 – S5) corroborated that they had not received a complaint from residents in care of the Administrator being verbally abusive or disrespectful towards a resident. All five (5) facility staff members - including the Administrator (Virginia Zenteno) confirmed that they have received training on the topics of Mandated Reporting and Personal Rights. RA Ceniceros reviewed the facility staffs’ training records on both topics and observed the training was conducted on 08/15/22, 08/17/22, and 08/18/22.

Based on the evidence gathered, interviews conducted, and records reviewed, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation of PERSONAL RIGHTS: Staff do not treat resident with respect is found to be UNSUBSTANTIATED.

Regarding Allegation #2: this investigation revealed based on interviews conducted of eight (8) residents (R1-R8), 6 of the 8 residents corroborated that if the main entrée is something a resident disagrees with at mealtime, then the resident has the option to order from the other two (2) meal options. Residents had no complaints about their dietary needs not being met. Residents confirmed that the facility provides salt and pepper at their dining table and the food tastes good. RA Ceniceros observed the posted 6-week menu in the dining/kitchen area (photo). The facility maintains a section board (in the kitchen area) with posted notes of those residents with special diet needs (photos). Interviews conducted of the other 2 of the 8 residents corroborated that the facility serves food that is seasoned with too much salt and some residents cannot have spices, onions and/or garlic. RA Ceniceros re-interviewed Staff #1 - #5 (S1 – S5) and 5 of the 5 corroborated that they had not received complaints from residents that their dietary needs are not being met or that the food is too salty with too much seasoning. RA toured the commercial-size kitchen and observed a food supply of regular and special diet meals. Administrator stated that the facility contracts with a dietary

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Elizabeth Ceniceros	TELEPHONE: (916) 224-1579
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20230123150309

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: PLAZA AT WESTWOOD, THE	FACILITY NUMBER: 198320197
	VISIT DATE: 08/09/2023

NARRATIVE

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consulting firm that sends out a dietician to review their dietary plans and 6-week menu on a quarterly basis. RA reviewed and obtained a copy of the dietary company’s invoice (dated 03/31/23).

Based on the evidence gathered, interviews conducted, and records reviewed, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation of PERSONAL RIGHTS: Staff do not meet dietary needs of resident is found to be UNSUBSTANTIATED.

An exit interview has been conducted and a copy of the Complaint Report was provided to the Administrator (Virginia Zenteno).

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Elizabeth Ceniceros	TELEPHONE: (916) 224-1579
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2023

LIC9099 (FAS) - (06/04)

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