198603220-7-3-2024-11-AS-UCOL-D7PVTQ-20240731164327

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603220
Report Date: 07/03/2024
Date Signed: 07/03/2024 04:55:31 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/28/2024 and conducted by Evaluator Regina Cloyd

COMPLAINT CONTROL NUMBER: 11-AS-20240628091240

FACILITY NAME:	CITY VIEW LA, LLC		FACILITY NUMBER:	198603220
ADMINISTRATOR:	HIRSCH, RENA		FACILITY TYPE:	740
ADDRESS:	515 N LA BREA AVE		TELEPHONE:	(323) 938-2131
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90036
CAPACITY:	166	CENSUS: 99	DATE:	07/03/2024
		UNANNOUNCED	TIME BEGAN:	08:47 AM
MET WITH:	Administrator Rena Hirsch		TIME COMPLETED:	05:10 PM

ALLEGATION(S):

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Staff serve food of poor quality.

INVESTIGATION FINDINGS:

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On 07/03/2024 Licensing Program Analyst (LPA) Regina Cloyd conducted a complaint investigation at the above facility to address the following allegation. LPA met with Administrator Rena Hirsch and explained the purpose of the visit. The investigation consisted of the following: During today’s investigation, LPA toured the kitchen, dining room, and storage space, reviewed records, and interviewed (10) residents and (10) staff members.

The investigation revealed the following: Regarding the allegation "Staff serve food of poor quality,” it is being alleged that staff serve cold food. LPA observed dish warmers to keep the food warm. Four (4) out of six (6) staff members, including the Administrator, indicated that food warmers are used to keep the dishes warm. Plus, the Cook indicated that the facility avoided serving hot meals while the kitchen was being remodeled. Seven (7) out of ten (10) residents indicated that the food is served warm and that staff is willing to reheat it when requested. Continue to LIC9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) -40-7397
LICENSING EVALUATOR NAME: Regina Cloyd	TELEPHONE: 323-981-7155
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024

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 11-AS-20240628091240

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: CITY VIEW LA, LLC	FACILITY NUMBER: 198603220
	VISIT DATE: 07/03/2024

NARRATIVE

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It is also being alleged that the facility sometimes run out of nonperishables for breakfast. Record review revealed that the facility serves hot and cold cereal in addition to oatmeal, waffles/muffins, and eggs. Six (6) out of eight (8) residents indicated that alternative nonperishables are provided for breakfast. Seven (7) out of eight (8) staff members, including the Administrator, indicated that alternative nonperishables are provided for breakfast if the facility runs out of one nonperishables. It is also being alleged that the Licensee will not serve a particular type of protein. Record review reveals that the facility serves a variety of protein options. Interview with the Administrator indicated that the facility will order (cater out) other protein options to accommodate residents with special requests. Finally, it is being alleged that the facility uses paper plates, plastic forks, and paper napkins. LPA observed metal silverware and cloth napkins in the dining hall. Staff and residents indicated that plasticware was only used while the kitchen was being remodeled. Regarding the allegation “Staff serve food of poor quality,” based on observation, record review, and interviews, the Department found no evidence to support the allegation mentioned above. 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, as a result, the allegation is Unsubstantiated.

No deficiency was cited for this allegation.

An exit interview was conducted and a copy of this report was provided to the Administrator Rena Hirsch.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) -40-7397
LICENSING EVALUATOR NAME: Regina Cloyd	TELEPHONE: 323-981-7155
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2024

LIC9099 (FAS) - (06/04)

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