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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602608
Report Date: 03/02/2023
Date Signed: 03/02/2023 01:05:54 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
06/22/2021 and conducted by Evaluator Elizabeth Irra
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20210622103648
FACILITY NAME:GROVE AT CERRITOS, THEFACILITY NUMBER:
198602608
ADMINISTRATOR:CRENSHAW, CAMILLEFACILITY TYPE:
740
ADDRESS:11000 NEW FALCON WAYTELEPHONE:
(562) 865-9500
CITY:CERRITOSSTATE: CAZIP CODE:
90703
CAPACITY:163CENSUS: 130DATE:
03/02/2023
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Lilit ChaparyanTIME COMPLETED:
01:20 PM
ALLEGATION(S):
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Facility staff did not provide resident's medical records to resident's medical provider
Facility is charging resident for services that are not needed
Facility did not accept resident back to the facility after a hospitalization
Illegal eviction
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Elizabeth Irra conducted a subsequent visit to investigate the above allegations. LPA met with Lilit Chaparyan and discussed the purpose of today's visit.

The initial 10-day investigation visit was conducted on 06/30/21 by LPA Linda Almaraz. During this visit, LPA Almaraz conducted a complaint visit to investigate the allegations listed above. LPA met with Administrator, Brittney Buchannan and discussed the reason this visit. The investigation consisted of the following: LPA interviewed the Administrator and attempted to interview former Administrator, Krystal Jenkins, but is no longer an employee at the facility. LPA also attempted to speak to Staff #1 who was not present at the facility. LPA was not able to interview Resident #1 since the resident is no longer at the facility. LPA requested facility staff and resident roster, and Resident #1's file.

Refer to LIC 9099C for the continuation of this report.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Tony VasalloTELEPHONE: (323) 981-3977
LICENSING EVALUATOR NAME: Elizabeth IrraTELEPHONE: (323) 981-3979
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
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-20210622103648
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: GROVE AT CERRITOS, THE
FACILITY NUMBER: 198602608
VISIT DATE: 03/02/2023
NARRATIVE
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Allegation: Facility staff did not provide resident's medical records to resident's medical provider On 06/30/21, LPA Linda Almaraz interviewed the Administrator and attempted to interview former Administrator, Krystal Jenkins, but is no longer an employee at the facility. LPA also attempted to speak to Staff #1 who was not present at the facility. LPA was not able to interview Resident #1 since the resident was no longer at the facility. As of July 15, 2022, this facility is under a new management company (Oakmont Management Group, LLC) and this facility is now known as Ivy Park at Cerritos. Due to this change, R-1’s file was not kept. During today’s visit, LPA Irra interviewed Lilit Chaparyan (Executive Director) whom began employment at this facility September 2022 and was unable to determine which staff knew R-1. LPA interviewed Staff #2 (S-2) through Staff #4 (S-4) whom have worked at this facility prior to the change of the management company and continue to work at this facility. LPA was unable to further obtain information pertaining to R-1 as interviewed staff did not recall R-1.

Allegation: Facility is charging resident for services that are not needed On 06/30/21, LPA Linda Almaraz interviewed the Administrator and attempted to interview former Administrator, Krystal Jenkins, but is no longer an employee at the facility. LPA also attempted to speak to Staff #1 who was not present at the facility. LPA was not able to interview Resident #1 since the resident was no longer at the facility. As of July 15, 2022, this facility is under a new management company (Oakmont Management Group, LLC) and this facility is now known as Ivy Park at Cerritos. Due to this change, R-1’s file was not kept. During today’s visit, LPA Irra interviewed Lilit Chaparyan (Executive Director) whom began employment at this facility September 2022 and was unable to determine which staff knew R-1. LPA interviewed Staff #2 (S-2) through Staff #4 (S-4) whom have worked at this facility prior to the change of the management company and continue to work at this facility. LPA was unable to further obtain information pertaining to R-1 as interviewed staff did not recall R-1.

Refer to LIC 9099C for the continuation of this report.

SUPERVISOR'S NAME: Tony VasalloTELEPHONE: (323) 981-3977
LICENSING EVALUATOR NAME: Elizabeth IrraTELEPHONE: (323) 981-3979
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20210622103648
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: GROVE AT CERRITOS, THE
FACILITY NUMBER: 198602608
VISIT DATE: 03/02/2023
NARRATIVE
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Allegation: Illegal eviction On 06/30/21, LPA Linda Almaraz interviewed the Administrator and attempted to interview former Administrator, Krystal Jenkins, but is no longer an employee at the facility. LPA also attempted to speak to Staff #1 who was not present at the facility. LPA was not able to interview Resident #1 since the resident was no longer at the facility. As of July 15, 2022, this facility is under a new management company (Oakmont Management Group, LLC) and this facility is now known as Ivy Park at Cerritos. Due to this change, R-1’s file was not kept. During today’s visit, LPA Irra interviewed Lilit Chaparyan (Executive Director) whom began employment at this facility September 2022 and was unable to determine which staff knew R-1. LPA interviewed Staff #2 (S-2) through Staff #4 (S-4) whom have worked at this facility prior to the change of the management company and continue to work at this facility. LPA was unable to further obtain information pertaining to R-1 as interviewed staff did not recall R-1

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



Exit interview, a copy of this report and appeals rights were provided to Lilit Chaparyan (Executive Director)
SUPERVISOR'S NAME: Tony VasalloTELEPHONE: (323) 981-3977
LICENSING EVALUATOR NAME: Elizabeth IrraTELEPHONE: (323) 981-3979
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3