198602192-8-22-2023-28-AS-LHIS-CV5K9X-20230828074303

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602192
Report Date: 08/22/2023
Date Signed: 08/22/2023 03:36:29 PM

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 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
08/17/2023 and conducted by Evaluator Angelica Rea

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230817162758

FACILITY NAME:	SAKURA GARDENS AT LOS ANGELES		FACILITY NUMBER:	198602192
ADMINISTRATOR:	KONISHI, DANIEL		FACILITY TYPE:	740
ADDRESS:	325 S BOYLE AVE		TELEPHONE:	(323) 263-9651
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90033
CAPACITY:	177	CENSUS: 132	DATE:	08/22/2023
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Daniel Konishi		TIME COMPLETED:	03:50 PM

ALLEGATION(S):

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Staff not safeguarding resident’s personal belongings.
Staff not preventing resident’s room from getting broken in.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angelica Rea conducted an initial complaint visit in response to the allegation(s) listed above. LPA met with Administrator, Daniel Konishi, who assisted with today's visit.

Regarding the allegation that : Staff are not safeguarding resident’s personal belongings. The investigation consisted of interviews with Administrator, Staff #1 - Staff #3, and Resident #1 - Resident #6, and review of Resident #1's file. Administrator and staff interviewed denied the allegation. They stated that staff do safeguard residents personal belongings. Administrator and staff stated that resident #1 has expressed concerns that their personal belongings are missing, and staff have conducted an internal investigation. Administrator and staff stated that some of the items that were said to be missing, were located in resident #1's room. Residents interviewed were unable to corroborate the allegation. Five out of six residents interviewed stated that their belongings are safeguarded. Regarding the allegation that : Staff are not preventing resident’s room from getting broken into. The investigation consisted of interviews with Administrator, and Staff #1 - Staff #3, and Resident #1 - Resident #6, and review of Resident #1's file.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica Rea	TELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023

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 28-AS-20230817162758

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: 08/22/2023

NARRATIVE

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Administrator and staff interviewed denied the allegation. They stated that residents rooms are not being broken into to their knowledge. Administrator stated that resident #1 has expressed concerns that someone has broken into their room. Administrator said that there are cameras in the hallways, and they have not observed any resident rooms being broken into. Residents interviewed were unable to corroborate the allegation. Five out of six residents interviewed stated that no one has broken into their room, to their knowledge.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview was conducted with Mr. Konishi, and a copy of this report was provided.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica Rea	TELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2023

LIC9099 (FAS) - (06/04)

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