198320197-4-11-2023-11-AS-MVAO-CQZSPV-20230418140347

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320197
Report Date: 03/28/2023
Date Signed: 04/11/2023 09:33:08 AM

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
02/09/2023 and conducted by Evaluator Ana Soto

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20230209154413

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:	03/28/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Virginia Zenteno, Administrator		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Licensee does not ensure the facility has a certified administrator.

INVESTIGATION FINDINGS:

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This amended report supersedes report (LIC 9099) dated 02/15/23. Licensing Program Analyst (LPA) Ana Soto conducted a subsequent complaint investigation for the allegation listed above. Today’s complaint investigation was conducted with Virginia Zenteno, Administrator.

The investigation consisted of following: Interviews and Record reviews. On 02/15/23, LPA Soto interviewed S#1 -S#7, R#1 -R#7. LPA toured the 2nd floor office, dining room, library, and rooms #212,222, 227, 341, and 336. LPA requested and received the following documents on 02/15/23: Resident Roster, Staff Schedule, Complete change of administrator package.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ana Soto	TELEPHONE: (323) 383-8284
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023

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-20230209154413

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: 03/28/2023

NARRATIVE

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Based on the LPA's investigation, the investigation revealed the following. For Allegation – Licensee does not ensure the facility has a certified administrator. Interviews with S#1 - S#7 and R#2 - R#7, they all communicated that the administrator is always at the facility and they believe she is certified. They also communicated that the administrator is always accessible and available for any questions and/or concerns. She’s always walking around the facility checking in on residents and the daily running’s of the facility. The LPA reviewed the administrator's file and qualifications. She provided the LPA with all the documents needed be the certified administrator. She has been working for the facility for over 18 years. She has her valid certificate of administrator which expires on 09/29/23. She has the documents required under Title 22 regulations to be the certified Administrator of the facility. LPA will make the change of administrator to reflect Virginia Zenteno as the current certified administrator for the facility.

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.

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

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ana Soto	TELEPHONE: (323) 383-8284
LICENSING EVALUATOR SIGNATURE:	DATE: 03/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2023

LIC9099 (FAS) - (06/04)

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