198603220-11-7-2024-11-AS-UCOL-DB8PM8-20241121102556

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603220
Report Date: 11/07/2024
Date Signed: 11/07/2024 01:27:45 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
10/14/2024 and conducted by Evaluator Socorro Leandro

COMPLAINT CONTROL NUMBER: 11-AS-20241014140107

FACILITY NAME:	CITY VIEW LA, LLC		FACILITY NUMBER:	198603220
ADMINISTRATOR:	GINSBERG, MENDY		FACILITY TYPE:	740
ADDRESS:	515 N LA BREA AVE		TELEPHONE:	(323) 938-2131
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90036
CAPACITY:	166	CENSUS: 80	DATE:	11/07/2024
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Executive Director (Administrator) - Mendy Ginsburg		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff do not ensure facility provides food of good quality
Staff do not ensure facility provides adequate planned activities
Staff does not ensure facility is kept free of pests

INVESTIGATION FINDINGS:

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On 11/7/2024, the Department of Social Services (DSS) - Community Care Licensing Division (CCLD) staff delivered findings for the allegations listed above. CCLD staff explained the purpose of the visit to Executive Director - Mendy Ginsburg.

The investigation consisted of the following:

On 10/23/2024, CCLD staff interviewed 13 out of 98 residents and 7 out of 52 staff.
CCLD staff toured the kitchen, dining room, activity room, and the gym.
CCLD staff requested and gathered records such as, Resident records, Staff records, and Facility records.

On 11/6/2024, CCLD staff reviewed interviews conducted, facility records, and facility website.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024

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-20241014140107

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: 11/07/2024

NARRATIVE

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The investigation revealed the following:

Regarding the allegation “Staff do not ensure facility provides food of good quality”, it is being alleged that the facility does not provide many food options and does not serve healthy well-balanced meals (e.g. serves too many carbohydrates). Interviews conducted with residents revealed the following: 8 out of 13 residents denied the allegation; 4 out of 13 residents agreed with the allegation; 1 out 13 residents did not know if alleged allegation had occurred. Interviews conducted with staff revealed the following: 5 out of 7 staff denied the allegation; 2 out of 7 staff did not know if alleged allegation had occurred. Records reviewed indicated the following: facility menu from September 2024 to October 2024 offers a protein option during breakfast, lunch, and dinner. Facility menus state, “Alternate dishes are always available.” The “Alternative Menu” has vegetarian options and offers protein heavy meals. Observations indicated the following: on 10/23/2024 during lunch time, CCLD staff observed that residents were being served well-balanced meals; CCLD staff also observed residents receiving alternative meal options. Regarding the allegation, the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the allegation is unsubstantiated.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20241014140107

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: 11/07/2024

NARRATIVE

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Regarding the allegation “Staff do not ensure facility provides adequate planned activities”, it is being alleged that the facility’s planned activities are not mentally challenging nor engaging for residents in care; Furthermore, it is being alleged that there are not enough exercise options for residents in care. Interviews conducted with residents revealed the following: 8 out of 13 residents denied the allegation; 2 out of 13 residents agreed with the allegation; 3 out 13 residents did not know if alleged allegation had occurred. Interviews conducted with staff revealed the following: 5 out of 7 staff denied the allegation and 2 out of 7 staff agreed with the allegation. Records reviewed indicated the following: facility activity calendar from August 2024 to October 2024 demonstrates that the facility offers various forms of physical activities (e.g. shake it off Zumba), independent activities (e.g. painting/drawing), group activities (e.g. group karaoke), activities that are mentally challenging (e.g. brain teaser), and outings. Facility website indicates the following: the facility offers Tuesday outings to the community for example going to museums and shopping centers. Observations indicated the following: the facility has a 24-hour gym with exercise equipment and a large tv; residents can go in and exercise along with exercise videos. On 10/23/2024, CCLD staff observed a resident teaching three residents how to play poker in the activity room. Regarding the allegation, the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the allegation is unsubstantiated.

Regarding the allegation “Staff does not ensure facility is kept free of pests”, it is being alleged that the facility has pests, and the facility is doing nothing to address the issue. Interviews conducted with residents revealed the following: 8 out of 13 residents have not seen pests in the facility and 5 out 13 residents have seen pests in the facility. Interviews conducted with staff revealed the following: 5 out of 7 staff denied the allegation and 2 out of 7 staff did not know if alleged allegation had occurred. Records reviewed indicated the following: a pest control company services the facility twice a month. Observations revealed the following: on 10/23/2024, CCLD staff did not observe live pests in the facility. Regarding the allegation, the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the allegation is unsubstantiated.

No deficiencies were cited.

A copy of this report was provided to Executive Director Mendy Ginsburg

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Socorro Leandro
LICENSING EVALUATOR SIGNATURE:	DATE: 11/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/07/2024

LIC9099 (FAS) - (06/04)

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