198602192-1-10-2025-28-AS-DSIS-DDNQ7Z-20250207105556

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602192
Report Date: 01/10/2025
Date Signed: 01/10/2025 01:15:45 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
12/23/2024 and conducted by Evaluator Bennette Pena

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20241223145347

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: 131	DATE:	01/10/2025
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Alfonso Lozoya - Business Office Manager Noriko Ramirez - Resident Care Coordinator Josephen Tomoko Hino - Marketing Director		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Resident was sexually abused while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Bennette Pena conducted a subsequent visit to investigate the above allegation. LPA met with Tomoko Hino, Marketing Director and Alejandro Lozoya, Business Office Manager and explained the purpose of today’s visit. LPA spoke with Jina Maleksarkissian, Executive Director on the phone and discussed the purpose of the visit.

On 12/24/2024, LPA Cota conducted the initial 10-day complaint visit and obtained relevant documentation. During today's visit, LPA Pena obtained staff & resident rosters, Facility's Abuse Neglect and Exploitation Policy, Resident #1 (R1) files such as: Identification and Emergency Information (Face sheet), Pre Admission Application, Resident Assessment, Admission Agreement, Physician's report, Kaiser Hospital Discharge record (12/24/2024), Medication Administration Record (MAR) for Nov. 2024-Jan. 2025 and Incident Report (12/22/2024). LPA interviewed Staff #1 (S1)-Staff #5 (S5) and Resident #1 (R1)-Resident #12 (R12). LPA requested copies of R1's LA USC Hospital Discharge Record and latest staff training log for Zero Tolerance Policy and Mandated Reporting.******CONTINUED ON LIC 9099C*****

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025

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 28-AS-20241223145347

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: SAKURA GARDENS AT LOS ANGELES	FACILITY NUMBER: 198602192
	VISIT DATE: 01/10/2025

NARRATIVE

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The investigation revealed the following:

In regards to the allegation: "Resident was sexually abused while in care." It is alleged that a resident with dementia is potentially being sexually abused while in care due to being tested positive for HIV. Interviewed staff denied the allegation and indicated they have not witnessed nor received any complaints in regards to residents being sexually abused while in care. S1-S3 stated that R1 was taken to the hospital emergency room for an evaluation related to R1's unwitnessed fall. During the evaluation, LA USC hospital conducted various tests which included HIV and was tested positive. However, additional tests/retests were performed when R1 was moved to Kaiser hospital, and R1 tested negative for HIV and STDs. R1 was subsequently discharged from Kaiser hospital after a few days. S1 and F1 indicated that LA USC hospital made a mistake in giving them R1's HIV positive result. Interviewed staff indicated there are only female staff in Assisted Living who provide care and supervision for all the female residents. Interviews conducted with F1 and W1 indicated no additional concerns after R1 tested HIV negative. R1 stated that she feels safe in the community and denied being sexually abused. Interviewed residents indicated female staff provide them with assistance, especially bathing/showering. 12 out of 12 residents interviewed indicated they have not witnessed any type of sexual abuse nor have been inappropriately touched by staff. Interviewed residents stated that they have not heard any complaints related to this allegation and feel safe in the facility.

Based on statements and interviews conducted with residents and staff as well as reviewed files and documentation, there was not enough supportive evidence to corroborate the allegation.

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.

Exit interview and a copy of this report was provided to the Business Office Manager, Alfonso Lozoya.

SUPERVISORS NAME: David Sicairos
LICENSING EVALUATOR NAME: Bennette Pena
LICENSING EVALUATOR SIGNATURE:	DATE: 01/10/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2025

LIC9099 (FAS) - (06/04)

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