198320478-1-14-2025-11-AS-UCOL-DCZVTA-20250117154250

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320478
Report Date: 01/14/2025
Date Signed: 01/14/2025 04:32:49 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 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
12/06/2024 and conducted by Evaluator Regina Cloyd

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20241206104153

FACILITY NAME:	AVOCET AT PLAYA VISTA		FACILITY NUMBER:	198320478
ADMINISTRATOR:	MCGEVNA, KEITH M		FACILITY TYPE:	741
ADDRESS:	12490 FIELDING CIRCLE		TELEPHONE:	(424) 216-7788
CITY:	PLAYA VISTA	STATE: CA	ZIP CODE:	90094
CAPACITY:	286	CENSUS: 211	DATE:	01/14/2025
		UNANNOUNCED	TIME BEGAN:	12:42 PM
MET WITH:	Executive Director Keith McGevna		TIME COMPLETED:	04:40 PM

ALLEGATION(S):

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Staff did not ensure resident meals are planned with consideration for cultural and religious background and food habits of residents in care.

INVESTIGATION FINDINGS:

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The investigation consisted of the following:

On 12/12/2024, Community Care Licensing Division (CCLD) Staff conducted a complaint investigation at the above facility to address the following allegations. CCLD Staff conducted staff interviews, toured the facility, and reviewed facility records. On 01/14/25, CCLD Staff met with Executive Director Keith McGevna and explained the purpose of the visit. CCLD Staff interviewed one staff member and twelve residents.

Allegation:

Regarding the allegation "Staff did not ensure resident meals are planned with consideration for cultural and religious background and food habits of residents in care,” it is being alleged residents are scared to eat meat because management has not confirmed whether the meat is kosher; therefore, residents resort to eating fish. Continue to LIC9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025

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-20241206104153

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: AVOCET AT PLAYA VISTA	FACILITY NUMBER: 198320478
	VISIT DATE: 01/14/2025

NARRATIVE

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Record review revealed that the dinner menu (11/10 - 11/16/24) included kosher orange chicken, spaghetti and meatballs, mongolian beef, crusted lamb chops, and whole roasted chicken. Also, dinner menu (12/08/24 - 12/14/24) included kosher spaghetti bolognese, shepherd's pie, wine braised short ribs, ahi poke bowls, and mushroom stroganoff. Kosher Vendor #1 receipts included liver, whole chicken, breasts, beef, lamb sham, chicken thigh, turkey, boneless turkey breast, chicken wings, and boneless chicken leg. Kosher Vendor #2 receipts included boneless rib eye, ground beef, london broil, beef chuck eye - stew cut, boneless flanken, chicken liver, boneless skinless chicken breasts, boneless rib eye, and racks of lamb. Kosher Vendor #3 included chuck tail flap prime creek. During the kitchen tour, CCLD Staff observed whole chickens, wine braised short ribs, and raw chicken livers in the two kitchens. The label on the raw chicken livers was stamped with star that included the letter “k” and stated, “must be koshered by broiling,” and “packed by: Quality Kosher Monroe, NY 10950”. Seven out of night staff interviews indicated that the meat is Kosher. Two out of eight staff interviews indicated they did not know whether the meat was Kosher. Interview with the Executive Director (S1) indicated that the food vendors have not changed between the former Licensee and the current Licensee. Interview with the Head Chef indicated they have not changed Kosher vendors but have added non-kosher items onto the menu. Two out of five resident interviews indicated that cultural and religious preferences are considered on the menu. Three out of five resident interviews indicated that cultural and religious preferences are not considered on the menu. Five out of twelve resident interviews indicated that the meat is kosher because it comes from a kosher source. Four out of twelve resident interviews indicated that the meat is not kosher because of how it is prepared. One of the four residents indicated that the food is Jewish style but not kosher. Interview with S1 indicated that the facility does not have a kosher kitchen. Three out of twelve resident interviews indicated that they are not sure if the meat is kosher. Six out of ten resident interviews indicated are satisfied with the food served. Two out of ten resident interviews felt indifferent about the food served. Two out of ten resident interviews indicated are not satisfied with the food served.

Regarding the allegation “Staff did not ensure resident meals are planned with consideration for cultural and religious background and food habits of residents in care," based on record reviews, interviews, and observations, the Department found no evidence to support the allegation mentioned above. 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, as a result, the allegation is Unsubstantiated. No deficiency was cited for this allegation. An exit interview was conducted and a copy of this report was provided to the Executive Director Keith McGevna.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Regina Cloyd
LICENSING EVALUATOR SIGNATURE:	DATE: 01/14/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025

LIC9099 (FAS) - (06/04)

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