198320197-2-15-2023-11-AS-MVAO-CPPUG9-20230307143357

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320197
Report Date: 02/15/2023
Date Signed: 02/15/2023 01:32:56 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
02/09/2023 and conducted by Evaluator Perry Scott

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20230209104129

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:	02/15/2023
		UNANNOUNCED	TIME BEGAN:	09:57 AM
MET WITH:	Virginia Zenteno		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Facility failed to follow Covid-19 protocols

INVESTIGATION FINDINGS:

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On 2/15/2023, Licensing Program Analyst (LPA) Perry Scott conducted an initial 10-day complaint visit at this facility to gather information about the above allegation. LPA Scott called and conducted a risk assessment with Licensee, Steven Aron who confirmed the facility is Covid-19 free. LPA met with Virginia Zenteno, administrator, who assisted with the visit. LPA explained the purpose of the visit.

The investigation consisted of the following:

On 02/15/2023 from 10:00am-12:30pm, LPA interviewed the administrator Virginia Zenteno staff (S1), licensee Steven Aron (S2), staff 3-6 and residents 1-5. LPA obtained copies of the mitigation plan, resident/staff rosters, vaccination records, and resident/staff Covid-19 positive log.

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Perry Scott	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2023

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-20230209104129

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: 02/15/2023

NARRATIVE

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The investigation revealed the following: Allegation: Facility failed to follow Covid-19 protocols.

LPA interviewed Virginia Zenteno, administrator, and Steven Aron, licensee, about the allegation. Both stated that the facility is in full compliance and are following the rules as specified in CCLD Pins, and the Department of Public Health guidelines. Both stated that the facility is isolating residents who have tested positive for Covid-19 and are not allowing them to roam outside of their isolation area.

Both stated that once a resident has a confirmed diagnosis, they are isolated from the other residents and strict protocols are put in place to keep them well, as well as keep the other residents and staff from getting the virus. LPA asked if there was a policy that mandated staff to deliver packages to the residents, both denied that, and stated that sometimes they do it as a courtesy, but residents pick up their own packages that have been delivered to them.

LPA interviewed S3-S6 about the allegation and all verified that they have been trained in Covid-19 protocols and that all residents who have the virus are isolated. They all denied the allegation that the facility failed to follow Covid-19 protocols. All staff are mandated to wear proper PPE’s and follow DPH as well as CCLD guidelines for Covid-19 prevention.

On 02/15/23, LPA reviewed the facilities mitigation plan, reporting logs for all staff and residents and the review of the records revealed that the facility are adhering to and keeping the required documents to track and report both staff/residents who have been infected with Covid-19.

LPA interviewed R1-R5 about the facilities protocols for Covid-19 prevention, and 5 out 5 corroborated that all staff continue to wear their PPE’s, Covid-19 residents are isolated, and all other required measures are utilized to prevent the spread of the virus.

Based on interviews and a records review, there was insufficient evidence to support the allegation. 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 is unsubstantiated.

No deficiencies cited.

An exit interview was conducted with Virginia Zenteno, Administrator, and a copy of the report was provided.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Perry Scott	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2023

LIC9099 (FAS) - (06/04)

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