198603220-8-22-2024-11-AS-UCOL-D8ZPQ8-20240911113039

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603220
Report Date: 08/22/2024
Date Signed: 08/22/2024 04:55:49 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
10/02/2023 and conducted by Evaluator Regina Cloyd

COMPLAINT CONTROL NUMBER: 11-AS-20231002144008

FACILITY NAME:	CITY VIEW LA, LLC		FACILITY NUMBER:	198603220
ADMINISTRATOR:	GINSBURG, 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: 95	DATE:	08/22/2024
		UNANNOUNCED	TIME BEGAN:	08:22 AM
MET WITH:	Executive Director Mendy Ginsburg		TIME COMPLETED:	05:13 PM

ALLEGATION(S):

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Staff are not following food services sanitation practices which protect the food from contamination.
Residents are fed contaminated foods.
Facility is not kept free of pests.
Facility kitchen is not kept clean.
Staff yells at residents in care.

INVESTIGATION FINDINGS:

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On 08/22/2024 Licensing Program Analyst (LPA) Regina Cloyd and LPA Hollie Enriquez conducted a subsequent complaint investigation at the above facility to address the following allegation. LPA met with Executive Director Mendy Ginsburg and explained the purpose of the visit. The investigation consisted of the following: During today’s investigation, LPAs toured the kitchen and dining room, reviewed five staff records, and interviewed nine residents and nine staff members.

Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint visit on Monday, October 09. 2023. Upon arrival at the facility. LPA Bunker called the facility via telephone and conducted a Risk Assessment. Based on the assessment, the facility is cleared of COVID-19 infection. LPA Bunker met with Executive Director Mendy Ginsburg. LPA Bunker explained the purpose of today's visit. The investigation consisted of the following: Interviews conducted. LPA Bunker asked questions relevant to the nature of the complaint. LPA Bunker requested copies of supporting documents. During today's visit, we toured the facility kitchen for cleanliness. 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: 08/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

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 5

Control Number 11-AS-20231002144008

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: 08/22/2024

NARRATIVE

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We did not observe any litter, rodents, vermin, or insects. The food was protected against contamination. Staff and residents interviewed stated staff do not yell at residents in care. Due to time constraints, LPA Bunker will return at a later date to conclude the visit. There were no deficiencies cited. Exit interview conducted.

Allegation(s):
Staff are not following food services sanitation practices which protect the food from contamination.

The investigation revealed the following: Regarding the allegation "Staff are not following food services sanitation practices which protect the food from contamination,” it is being alleged that dishes are not washed properly and cleaning supplies such as rags to clean the dishes are rotten and moldy.

On 10/09/23, LPA Bunker observed that the food was protected against contamination. On 08/22/24, LPA Enriquez observed an Alsco bag for both clean and soiled rags in the kitchen. Seven (7) out of seven (7) kitchen and dining staff interviews, including the Executive Director, indicated that the soiled rags go into a designated bag and are picked up by the vendor weekly. Interview with the Executive Director also indicated that the facility has received Alsco services prior to October 2023. LPA also observed that the kitchen has a three step cleaning process and a commercial dishwash sanitizer machine. Six (6) out of nine (9) staff interviews indicated that the dishes are rinsed, slightly washed, and ran through the dishwasher. Four (4) out of nine (9) resident interviews indicated that the utensils and dishware appeared to be clean and that staff washed them. Five (5) out of nine (9) resident interviews indicated that utensil looked moderately cleaned and occasionally have some food remnants or grease on them. Regarding the allegation “Staff are not following food services sanitation practices which protect the food from contamination,” based on observation 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.

Continue to LIC9099-C.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) -40-7397
LICENSING EVALUATOR NAME: Regina Cloyd	TELEPHONE: 323-981-7155
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 11-AS-20231002144008

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: 08/22/2024

NARRATIVE

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Allegation(s):
Residents are fed contaminated foods.

The investigation revealed the following: Regarding the allegation "Residents are fed contaminated foods,” it is being alleged that poultry such as chicken and meats are being left out for over a day and is then being fed to elders.

LPA observed a deep freezer of frozen meats, thawed meats in the original packaging and in bins on the lowest rack in the refrigerator, and the designated sink for rinsing meats after thawing. Seven (7) out of nine (9) staff interviews indicated that frozen meats are thawed in the refrigerator and then moved to the sink for preparation. One (1) out of nine (9) staff members was unaware of the process but stated that she/he has never seen food left out. Six (6) out of nine (9) resident interviews indicated that the quality of food and meats are good. Two (2) out of nine (9) residents did not like the quality of food and meats but acknowledged that the meat was not spoiled or rancid. Record review reveals that two (2) Cooks, the Dining Room Manager, Culinary Director, and Kosher Director all have valid California Food Handler cards or course completion certificates. Regarding the allegation “Residents are fed contaminated foods,” based on observation, interviews, and record review, 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.

Allegation(s):
Facility is not kept free of pests.

The investigation revealed the following: Regarding the allegation "Facility is not kept free of pests,” it is being alleged that the kitchen has a huge pest and rodent issue (roaches, rats, etc). On 10/09/23, LPA Bunker toured the facility kitchen for cleanliness and did not observe any litter, rodents, vermin, or insects. On 08/22/24, LPA Enriquez did not observe signs of rodents or vermin in the kitchen. Five (5) out of seven (7) staff interviews indicated that the facility had a rodent and/or vermin issue in October 2023. Four (4) out of seven (7) staff interviews indicated that the issue was addressed. Two staff members were unsure.
Continue to LIC9099-C.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) -40-7397
LICENSING EVALUATOR NAME: Regina Cloyd	TELEPHONE: 323-981-7155
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 11-AS-20231002144008

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: 08/22/2024

NARRATIVE

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Eight (8) out of nine (9) resident interviews indicated they have never seen any rodents (rats or mice) in the entire facility. Record review revealed that the facility received pest control services on 09/07/23, 09/14/23, 09/21/23, 10/05/23, 10/19/23, 11/02/23, and 11/16/23. Each work order included services in the kitchen and dining room area. Regarding the allegation “Facility is not kept free of pests,” based on observation, interviews, and record review, 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.

Allegation(s):
Facility kitchen is not kept clean.

The investigation revealed the following: Regarding the allegation "Facility kitchen is not kept clean,” it is being alleged that the kitchen is extremely dirty. On 08/22/24, six (6) out of seven (7) staff interviews indicated that the kitchen is cleaned daily. One staff member indicated that the dining room remained cleaned. One staff member was unsure of the kitchen cleaning schedule. Interview with the Culinary Director indicated that once they finish cooking, they clean the line and the mats. At 11:30 AM, after breakfast but before lunch, LPA toured the kitchen and observed some disorganization but no sanitation issues. Regarding the allegation “facility kitchen is not kept clean,” based on interviews and observations, 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.

Continue to LIC9099-C.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) -40-7397
LICENSING EVALUATOR NAME: Regina Cloyd	TELEPHONE: 323-981-7155
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 11-AS-20231002144008

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: 08/22/2024

NARRATIVE

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Allegation(s):
Staff yells at residents in care.

The investigation revealed the following: Regarding the allegation "Staff yells at residents in care,” it is being alleged that staff yell at residents when residents ask for certain things such as snacks or food.

On 08/22/24 8:39 AM and 12:25 PM, LPA Enriquez observed three servers attending to the meal needs of the residents and one to two caregivers stationed at the entryway who assisted with activities of daily living. Eight (8) out of nine (9) staff interviews indicated they have not yelled at residents when they requested for snacks or food. Nine (9) out of nine (9) resident interviews indicated staff has never yelled at them at for anything and would receive a snack if requested. Regarding the allegation “Staff yells at residents in care,” based on observation 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 Executive Director Mendy Ginsburg.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) -40-7397
LICENSING EVALUATOR NAME: Regina Cloyd	TELEPHONE: 323-981-7155
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2024

LIC9099 (FAS) - (06/04)

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