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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 198603220
Report Date: 09/27/2024
Date Signed: 09/27/2024 02:21:49 PM


Document Has Been Signed on 09/27/2024 02:21 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245



FACILITY NAME:CITY VIEW LA, LLCFACILITY NUMBER:
198603220
ADMINISTRATOR:GINSBERG, MENDYFACILITY TYPE:
740
ADDRESS:515 N LA BREA AVETELEPHONE:
(323) 938-2131
CITY:LOS ANGELESSTATE: CAZIP CODE:
90036
CAPACITY:166CENSUS: 103DATE:
09/27/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
01:38 PM
MET WITH:Mendy GinsburgTIME COMPLETED:
03:00 PM
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On 09/27/24, Licensing Program Analyst (LPA) Elvira Gonzalez conducted a case management inspection visit at this facility. LPA met with Mendy Ginsburg, Administrator, and explained that the purpose of the visit is in association with a complaint investigation conducted on 09/09/24 and on 09/19/24 for complaint # 11-AS-20240906101758.
During the investigation visit on 09/19/24, LPA Gonzalez observed a sign that read “No Outside Food or Drink” in the dining room while conducting a facility tour.

A review of the facility’s House Rules included in the facility’s Plan of Operation, and the Resident Handbook provided by the Administrator Mendy Ginsburg does not state that residents are not allowed to bring any outside food into the facility and/or the dining room.

Technical Violation – Advisory Notes(LIC 9102) issued during this visit.

No Deficiencies were identified during this inspection visit.



An exit interview was conducted, and a copy of this report was provided to Mendy Ginsburg.
SUPERVISOR'S NAME: Stephanie CifuentesTELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Elvira GonzalezTELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:
DATE: 09/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/27/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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