198602192-9-12-2024-28-AS-RORN-D9NVFU-20241002162432

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602192
Report Date: 09/12/2024
Date Signed: 09/12/2024 06:54:23 PM

Substantiated

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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/05/2024 and conducted by Evaluator Nune Margaryan

COMPLAINT CONTROL NUMBER: 28-AS-20240905151659

FACILITY NAME:	SAKURA GARDENS AT LOS ANGELES		FACILITY NUMBER:	198602192
ADMINISTRATOR:	JINA MALEKSARKISSIANS		FACILITY TYPE:	740
ADDRESS:	325 S BOYLE AVE		TELEPHONE:	(323) 263-9651
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90033
CAPACITY:	183	CENSUS: 130	DATE:	09/12/2024
		UNANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Tomoko Hino, Marketing Director		TIME COMPLETED:	07:00 PM

ALLEGATION(S):

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Licensee does not ensure that residents are provided with a comfortable environment while in care.
Facility is in disrepair.

INVESTIGATION FINDINGS:

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During today's visit, Licensing Program Analyst (LPA) Nune Margaryan conducted an initial complaint visit to investigate the allegations listed above. LPA met with Tomoko Hino, Marketing Director. Administrator Jina Malesarkissians arrived shortly thereafter.

The inspection consisted of the following: LPA conducted a tour of facility including kitchen, dining room, common areas. LPA obtained staff and resident rosters, a copy of documents pertaining to this complaint, interviewed Administrator, Staff 1 - Staff 3 (S1 - S3) and Resident 1 - Resident 12 (R1 - R12).

Continue 9099C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3378
LICENSING EVALUATOR NAME: Nune Margaryan	TELEPHONE: 323-981-3378
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024

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 28-AS-20240905151659

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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: SAKURA GARDENS AT LOS ANGELES	FACILITY NUMBER: 198602192
	VISIT DATE: 09/12/2024

NARRATIVE

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Allegation: Licensee does not ensure that residents are provided with a comfortable environment while in care. It was alleged that the residents cannot eat comfortably because facility had failed to provide adequate air conditioning and the residents are suffering tremendous heat in the dining room.
LPA interviewed 12 residents and 10 out of 12 residents reported the air conditioner in the dining room was not working and the temperature was very high in the dining room. Interviewed residents stated that there are 2 portable A/C units were installed in the dining room couple of days ago but was not enough to maintain a comfortable temperature. Interviewed Administrator and staff admitted that dining room was very hot when it was extreme hot a week ago. Interviewed Administrator stated that the dining room temperature was suitable and comfortable up until recent heat wave on 09/05/24. To which they coordinated the portable AC units to be installed. Also stated more AC units will be installed in the dining room. Interviewed S2 stated that 4 AC units were provided, which had no effect in the kitchen and dining room.

Allegation: Facility is in disrepair. It was alleged that the air conditioner in the dining room has not been working for the past 6 months.

During visit, LPA toured the physical plant along with S1 and observed that the AC unit is missing from the cage in the back of facility. Interviewed Administrator and staff stated that about 6 mounts ago AC unit was stolen. Interviewed Administrator stated that facility was faced with theft due to trespassers who vandalized the building. Administrator stated that they communicated with the home office and construction team to look for alternative measures such as adding wrought iron gates to the back end of the property as well to better secure. The AC unit to be manufactured and once in placed they need to cage it off with the wrought iron to prevent future damage and theft. However A/C unit was stolen about 6 mouths ago and until today was not replaced / restored

Based on interviews conducted and observations, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED.

Deficiencies are cited. See LIC9099D.

An exit interview was conducted with Administrator and the copy of this report and appeal right were provided.

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3378
LICENSING EVALUATOR NAME: Nune Margaryan	TELEPHONE: 323-981-3378
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20240905151659

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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: SAKURA GARDENS AT LOS ANGELES	FACILITY NUMBER: 198602192
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/12/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/19/2024 Section Cited HSC 87303(b)	1 2 3 4 5 6 7	Maintenance and Operation. (b) A comfortable temperature for residents shall be maintained at all times. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Licensee / Administrator will ensure that comfortable temperature/ environment will maintained for residents and agreed to purchase additional portable AC units to place in the dining room. Proof will be submitted to CCL/LPA by POC due date.
	8 9 10 11 12 13 14	Based on observation and interviews, the Licensee / Administrator did not comply with the section cited above. Dining room temperature was extreme hot a week ago, which poses a potential health and safety risk to residents in care.	8 9 10 11 12 13 14
Type B 09/30/2024 Section Cited CCR 87307(d)(2)	1 2 3 4 5 6 7	Personal Accommodations and Services (d) The following space and safety provisions shall apply to all facilities:(2) The premises shall be maintained in a state of good repair and shall provide a safe and healthful environment. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	Licensee / Administrator confirm that AC unit will be purchased and proof of purchase will be submitted to CCL / LPA by POC due date.
	8 9 10 11 12 13 14	Based on observation and interview, the Licensee / Administrator did not comply with the section cited above. A/C unit was stolen about 6 mouths ago and until today was not replaced / restored	8 9 10 11 12 13 14

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3378
LICENSING EVALUATOR NAME: Nune Margaryan	TELEPHONE: 323-981-3378
LICENSING EVALUATOR SIGNATURE:	DATE: 09/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2024

LIC9099 (FAS) - (06/04)

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