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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602192
Report Date: 03/10/2025
Date Signed: 03/10/2025 11:00:40 AM

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
02/28/2025 and conducted by Evaluator Glenn Trueman
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250228153319
FACILITY NAME:SAKURA GARDENS AT LOS ANGELESFACILITY NUMBER:
198602192
ADMINISTRATOR:JINA MALEKSARKISSIANSFACILITY TYPE:
740
ADDRESS:325 S BOYLE AVETELEPHONE:
(323) 263-9651
CITY:LOS ANGELESSTATE: CAZIP CODE:
90033
CAPACITY:183CENSUS: 126DATE:
03/10/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Executive Director Dennis RobeniolTIME COMPLETED:
11:15 AM
ALLEGATION(S):
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Staff did not ensure the facility generators were not in disrepair
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Glenn Trueman conducted a complaint investigation regarding the allegation above. LPA arrived unannounced and met with Executive Director Dennis Robeniol. The purpose for the visit was explained.
LPA obtained a copy of the staff and resident roster.
LPA interviewed Executive Director Dennis Robeniol and Staff S1.
LPA and Staff S1 toured the exterior of the facility where the generators for the facility are located.
In regards to the allegation Staff did not ensure the facility generators were not in disrepair, based on interviews conducted, tour conducted and information gathered it was revealed by the Executive Director that the generators have been non-operable for at least a year.
Stated that the copper wires connected to the generators were stolen by individuals from outside the facility.
Said the blackout was about 2 hours in the facility.
Interview with Staff S1 who stated that all the wiring was stolen and that the generators have been non-operable for 1 year.
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 28-AS-20250228153319
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: 03/10/2025
NARRATIVE
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Said he believed the homeless took all the copper and the wiring.
Stated that the blackout was the 1st time that it happened and lasted 2 hours and that residents were in dining room where there was good lighting.
Tour of the exterior of the facility where the generators are located LPA observed wires cut that lead to the motor and to the breakers which made it non-operable.

Based on LPA’s observations, tour and interviews conducted, the preponderance of evidence standard has been met, therefore, the allegation has been determined to be SUBSTANTIATED. Deficiency cited on LIC 9909-D.

Exit interview was conducted with Executive Director.

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/10/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20250228153319
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: 03/10/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/17/2025
Section Cited
CCR
87303(a)
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Maintenance and Operations
The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
This requirement is not met as evidenced by:
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Licensee/ Administrator will submit by POC due date the vendor who will repair the generator and also the date for when it will be completed and submit proof to LPA when it has been repaired.
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Based on interviews conducted, tour conducted and information gathered the facility was not kept in good repair with generator non-operable which poses a potential health and safety risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/10/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3