198602881-3-3-2022-11-AS-EMAZ-CCRV2W-20220322160346

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602881
Report Date: 03/01/2022
Date Signed: 03/03/2022 07:48:09 AM

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 DR #100
MONTERY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/24/2022 and conducted by Evaluator Ernand Dabuet

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20220224141527

FACILITY NAME:	SUNRISE VILLA CULVER CITY		FACILITY NUMBER:	198602881
ADMINISTRATOR:	COLLINS, BRANDON		FACILITY TYPE:	740
ADDRESS:	4061 GRAND VIEW BLVD		TELEPHONE:	(310) 390-0565
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90066
CAPACITY:	150	CENSUS: 71	DATE:	03/01/2022
		UNANNOUNCED	TIME BEGAN:	09:49 AM
MET WITH:	Safoora Ahmed Executive Director		TIME COMPLETED:	03:57 PM

ALLEGATION(S):

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A comfortable temperature is not maintained in resident's apartment.

INVESTIGATION FINDINGS:

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On 03/01/22 Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced complaint visit at this facility. LPA met with Executive Director Seafora Ahmed and explained the purpose of today's visit is to gather information for the allegation mentioned above.

The investigation consisted of the following: LPA inquired questions relevant to the nature of the complaint. Interviews with staff #1 - #2 (S1-S2) and residents #1-#7 (R1-R7). Temperature assessments in rooms #201, #203, #205, and #211 were performed. A copy of (R1's) physician report, resident appraisal, medications, and other documents pertinent to the allegation were examined. An inspection of the entire facility was conducted.

Evaluation Report continues on LIC 9099

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Ernand Dabuet	TELEPHONE: (323) 629-5526
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022

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 11-AS-20220224141527

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 DR #100
MONTERY PARK, CA 91754

FACILITY NAME: SUNRISE VILLA CULVER CITY	FACILITY NUMBER: 198602881
	VISIT DATE: 03/01/2022

NARRATIVE

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INVESTIGATION REVEALED THE FOLLOWING:
Allegation: A comfortable temperature is not maintained in resident's apartment.
It is alleged that the facility has failed to provide a comfortable temperature in resident #1 (R1’s) apartment. The complainant reports the (R1’s) #205 apartment is either too cold or it is too hot. It is never a comfortable temperature and that (R1) has a problem breathing. The complainant claims the heater is on, it creates a loud noise and produces a foul odor. The Department conducted a visit in (R1’s) apartment and performed a room temperature assessment at 1:03 pm with a wireless digital thermometer. The test revealed the room temperature at 78 degrees F with no air conditioning or heater on. The air conditioning was turned on and the temperature dropped down to 76-77 degrees F and when heating was sampled it brought it back to 78-79 degrees F. The air conditioning and heating system were working properly, and it did not cause a loud noise or disbursed a foul odor when the air or heater was on. An interview with (R1) claims that the maintenance and administrative staff have been made aware of the ongoing problem. but also claims that staff has been responsive to address this issue. (R1) still persists there is a problem even though it has been inspected. An interview with the executive director (S1) and maintenance director (S2) both argue that (R1) has addressed her problems only with the system making loud noises and did not have any knowledge of the temperature or the foul odor. Interviews with residents #2 - #7 (R2-R7) all stated that had no concerns with room temperatures in their apartments. (R2-R7) all reported that management is responsive when it comes to repairs or maintenance services. (S2) states the facility does not have central air or heating and that each apartment has an individual air and heating system. The Department conducted assessments in rooms #201, #203, and #211 and found temperature readings at normal 78 degrees F, and all systems were working properly. A certified ac/heating specialist was contacted by management who performed service in (R1's) apartment on 03/01/22, indicated no prominent issues with the system.

Based on information gathered, an inspection of the facility, observation, analysis records of (R-1)'s service records, interviews, and temperature test conducted, the Department found no evidence to support the allegation "A comfortable temperature is not maintained in resident's apartment."

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

An exit interview with Safoora Ahamed and a copy of the report were provided.

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Ernand Dabuet	TELEPHONE: (323) 629-5526
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2022

LIC9099 (FAS) - (06/04)

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