198320197-11-9-2022-11-AS-MVAO-CM5U5Q-20221215141706

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320197
Report Date: 11/09/2022
Date Signed: 11/09/2022 02:24:32 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
11/04/2022 and conducted by Evaluator Troy Agard

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20221104171107

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: 58	DATE:	11/09/2022
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Virginia Zenteno, Administrator		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Inadequate staffing to meet the needs of the resident's.
Facility did not provide requested documents to resident's representative.

INVESTIGATION FINDINGS:

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On 11/09/2022, Licensing Program Analyst (LPA) Troy Agard conducted an initial complaint investigation to address the allegations listed above. LPA Agard met with Virginia Zenteno, Administrator and explained the purpose of this visit is to gather information for the complaint and deliver findings.

The investigation consisted of the following: LPA Agard conducted a tour of the facility grounds. Facility is a 68 resident-bedroom, approx.74-bathroom, three-story building. 1st floor consists of a lobby area, laundry facility, staff break room and an adjacent parking structure. 2nd floor consists of residential rooms, dining room, kitchen, outdoor patio, media room and medication room. 3rd. floor consist of residential rooms. LPA interviewed staff and residents, reviewed records, and delivered findings. LPA Agard requested the following documents: 1) A copy of the staff roster, 2) a copy of the resident roster with their date of birth, 3) staffing schedules. Documents were received at the time of visit.

Cont. on 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Troy Agard	TELEPHONE: (323) 400-7109
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022

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-20221104171107

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: PLAZA AT WESTWOOD, THE	FACILITY NUMBER: 198320197
	VISIT DATE: 11/09/2022

NARRATIVE

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The investigation revealed the following...regarding the allegation: Inadequate staffing to meet the needs of the residents. It’s being alleged that several residents state the facility is understaffed and when the resident’s outreach to the facility the need is ignored or answered in a delay time period.” During interviews with the residents, LPA interviewed 6 out of 58 residents in total. 1 out of 6 confirm the allegation. R1 states, “I think they are running on less staff from what I heard. I think yes, they don’t have enough staff.” R2 states, “yes, there are enough staff that work here. They are meeting my needs. I feel safe.” R3 states, “As far as the staff, I’m fine with the staff.” R6 states, “There are enough staff. I mean I don’t need that much but the staffing pattern is fine here.

During interviews with staff, LPA interviewed 4 out of 40 in total. 2 out of 4 confirm the allegation. S1 states, “we have a staff shortage, but we have been hiring from an agency for every single shift.” S2 states, “I think so, yea. We do need more staff because sometimes there’s no help for the residents. Sometimes they need help in the dining room.” S3 states, “we can use more in the area of caregiving. Sometimes we are short staff but it’s not always and we have been using agency so it’s a big help.” S4 states, “we are using agency to fill in the vacancies. When we have agency there is enough. We just have to orient them on the resident’s personality or needs.”

Regarding the allegation: Facility did not provide requested documents to resident's representative. It’s being alleged the facility failed to send an incident report involving residents. During interviews with the residents, 0 out of 6 confirmed the allegation. R1-R6 unanimously all agreed to not having experienced the allegation and was unable to provide any context related to the allegation. During interviews with staff, 1 out of 4 confirmed the allegation. S1 states, “I kept forgetting to send it. I called and stated that I didn’t forget about faxing it, but I have been taking care of the facility. S2-S4 unanimously all agreed to not knowing about the allegations and was unable to provide any context related to the allegation.

During a record review, LPA observed invoices billed to the facility for the month of September and October for the use of a staffing agency. LPA observed agency staff filling in vacant shifts throughout both months. LPA observed Administrator fax a copy of an incident report and provided a copy of the fax confirmation to LPA which showed documents were sent to resident’s representative.

Based on LPA’s observation, interviews conducted, and record review, the preponderance of evidence standard has not been met. Although the allegations 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 allegations are unsubstantiated.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Troy Agard	TELEPHONE: (323) 400-7109
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022

LIC9099 (FAS) - (06/04)

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