198602192-3-20-2024-28-AS-TVAO-D4TMNQ-20240430094554

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602192
Report Date: 03/20/2024
Date Signed: 03/20/2024 04:02:44 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
03/15/2024 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240315143603

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:	183	CENSUS: 129	DATE:	03/20/2024
		UNANNOUNCED	TIME BEGAN:	12:28 PM
MET WITH:	Jina Maleksarkissian, administrator		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Administrator is not at the facility for the required amount of time.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cynthia Chan conducted a complaint investigation regarding the allegation above. LPA arrived unannounced and met with Administrator, Jina Maleksarkissian. The purpose for the visit was explained.

LPA obtained a copy of the staff and resident roster. LPA also reviewed the administrator's file and interviewed the administrator, 6 staff and 5 residents.

For allegation, administrator is not at the facility for the required amount of time. It is alleged that the administrator is not available for residents and staff and is not in the building. LPA interviewed the administrator who started on 2/21/24. She stated she works Monday through Friday, 9:30am - 5pm, and is available on call. She is normally in the building except when she has any business meetings or business developments. She will attend the meeting and return to the community right after.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Tony Vasallo	TELEPHONE: (323) 981-3977
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024

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-20240315143603

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: 03/20/2024

NARRATIVE

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Per the administrator, she had introduced herself to the residents when she first started and held meetings to get acquainted with staff. LPA interviewed 6 staff and they all stated the administrator is available when needed. 4 out of the 5 residents can identify the administrator and stated she is often at the facility.

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.

An exit interview was conducted with the administrator. A copy of this report along with the appeal rights were provided.

SUPERVISOR'S NAME: Tony Vasallo	TELEPHONE: (323) 981-3977
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2024

LIC9099 (FAS) - (06/04)

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