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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603220
Report Date: 10/15/2025
Date Signed: 10/15/2025 12:00:45 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/13/2025 and conducted by Evaluator Mario Leon
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20250513155247
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: 116DATE:
10/15/2025
UNANNOUNCEDTIME BEGAN:
09:38 AM
MET WITH:Vanita Harris - Business office managerTIME COMPLETED:
12:19 PM
ALLEGATION(S):
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Staff are not following resident's special diet order
INVESTIGATION FINDINGS:
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On 10/15/25 Licensing Program Analyst (LPA) Mario Leon conducted a subsequent, unannounced, complaint visit at the facility to deliver these findings. LPA was met by staff five, Vanita Harris - Business Office Manager (S5), and the purpose of the visit was explained.
The investigation consisted of the following: On 05/21/25 LPA requested and reviewed facility documents, inlcuding resident roster (dated: 05/21/25), resident special diet list (dated 05/21/25) staff roster (dated: 05/05/25), four (4) physician's special diet orders and toured the first (1st) and fourth (4th) floors of the facility. LPA interviewed six (6) out of one-hundred and five (105) clients (R1 through R6) and four (4) out of seventy-six (76) staff (S1 through S4). On 07/16/25 LPA requested resident roster (dated 07/16/25) and toured the third (3rd) and fifth (5th) floors of the facility. LPA interviewed three (3) residents (R7 through R9) and three (3) staff (S7 through S9). Resident(s) six (R6) and nine (R9) have denied holding an interview with LPA.
Report continues, please see LIC9099C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2025
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 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/13/2025 and conducted by Evaluator Mario Leon
COMPLAINT CONTROL NUMBER: 11-AS-20250513155247

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: 116DATE:
10/15/2025
UNANNOUNCEDTIME BEGAN:
09:38 AM
MET WITH:Vanita Harris - Business office managerTIME COMPLETED:
12:19 PM
ALLEGATION(S):
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9
Staff are not providing resident with enough food to meet resident's needs
Staff did not safeguard resident's belongings
Staff do not answer residents calls for assistance timely
Staff did not administer resident's meds timely causing resident to miss medications
INVESTIGATION FINDINGS:
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On 10/15/25 Licensing Program Analyst (LPA) Mario Leon conducted a subsequent, unannounced, complaint visit at the facility to conduct further complaint investigation. LPA was met by staff five, Vanita Harris - Business Office Manager (S5), and the purpose of the visit was explained.
The investigation consisted of the following: On 05/21/25 LPA requested and reviewed facility documents, inlcuding resident roster (dated: 05/21/25), resident special diet list (dated 05/21/25) staff roster (dated: 05/05/25), four (4) physician's special diet orders and toured the first (1st) and fourth (4th) floors of the facility. LPA interviewed six (6) out of one-hundred and five (105) clients (R1 through R6) and four (4) out of seventy-six (76) staff (S1 through S4). On 07/16/25 LPA requested resident roster (dated 07/16/25) and toured the third (3rd) and fifth (5th) floors of the facility. LPA interviewed three (3) residents (R7 through R9) and three (3) staff (S7 through S9). Resident(s) six (R6) and nine (R9) have denied holding an interview with LPA.
Report continues, please see LIC9099C.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 11-AS-20250513155247
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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, LLC
FACILITY NUMBER: 198603220
VISIT DATE: 10/15/2025
NARRATIVE
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The investigation revealed the following:

Regarding the allegation, “Staff are not providing resident with enough food to meet resident's needs”, it has been alleged that a resident is not provided enough protein in their daily diet. On 05/21/25, at around 09:30AM toured the facility’s kitchen and observed three (3) residents’ special dietary orders (R2-R4), located on the cork board as LPA entered the kitchen. At around 1:00PM, LPA collected four residents’ (R1-R4) dietary orders. Upon review of four residents’ dietary orders (DO), R1’s physicians’ DO does not mention any increase in protein for R1. During an interview with R1, R1 mentions that he is provided with about one and a half (1.5) chicken breasts, instead of three (3) chicken breasts as requested. Interviews revealed that three (3) out of four (4) residents and seven (7) out seven (7) staff have not agreed with this allegation. Based on LPA’s observation, record reviews and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.

Regarding the allegation, “Staff did not safeguard resident's belongings”, it is being alleged that nine (9) residents’ underwear have not been returned after being provided to housekeeper(s). On 05/21/25, at around 1:00PM, LPA requested any documentation of residents’ concerns regarding their personal belongings. LPA reviewed a residents’ safeguard of personal belongings, in which does not mention nine (9) pair of underwear. Interviews revealed that three (3) out of seven (7) residents and seven (7) out seven (7) staff have not agreed with this allegation. Based on LPA’s observation, record reviews and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.

Report continues, please see LIC9099C.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 11-AS-20250513155247
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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, LLC
FACILITY NUMBER: 198603220
VISIT DATE: 10/15/2025
NARRATIVE
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Regarding the allegation, “Staff do not answer residents calls for assistance timely”, it is being alleged that a resident must wait about one (1) hour to have their incontinence supply changed. At around 1:00PM, LPA reviewed a residents’ “caretrack” regarding toileting provided to a resident. According to caretrack, a resident was provided toileting assistance at 9:00PM and at 11:00PM, 01:00AM, 03:00AM and at 05:00AM. Interviews revealed that six (6) out of seven (7) residents and seven (7) out of seven (7) staff have denied the allegation has taken place. Based on LPA’s record reviews and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.

Regarding the allegation, “Staff did not administer resident's meds timely causing resident to miss medications”, it is being alleged that a residents’ cream was not administered on the date of 05/08/25. At around 1:00PM, LPA reviewed a residents’ caretrack. On 05/08/25, caretrack notes the cream mentioned as having been provided at the following times: 08:00AM, 12:00PM and 5:00PM. Interviews have revealed that five (5) out of seven (7) residents and seven (7) out of seven (7) staff have denied the allegation has taken place. Based on LPA’s record reviews and interviews conducted, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred. Therefore, the above allegation has been Unsubstantiated.

There has been one deficiency cited during today's visit, please see LIC9099D.

An exit interview was held with Vanita Harris - Business Office Manager and a copy of this report has been provided.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 11-AS-20250513155247
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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, LLC
FACILITY NUMBER: 198603220
VISIT DATE: 10/15/2025
NARRATIVE
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Regarding the allegation, “Staff are not following resident's special diet order”, it is being alleged that the facility is not following a residents' physician diet order. On 05/21/25, at around 09:30AM, LPA toured the facility’s kitchen and observed three (3) residents’ special dietary orders (R2-R4), located on the cork board as LPA entered the kitchen. R1’s diet was not observed. At around 1:00PM, LPA collected four residents’ (R1-R4) dietary orders (DO). R1’s special diet was created by their physician on 04/30/25, yet was not posted as other residents’ (R2-R4) DO was. Interviews revealed that four (4) out of seven (7) residents have agreed that the allegation has taken place. Based on LPA’s observation, record reviews and interviews conducted, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be Substantiated. California Code of Regulations, Title twenty-two (22), Division six (6) is being cited on the attached LIC 9099D. Please see LIC9099D.

One deficiency was cited during today's visit, please see LIC9099D.

An exit interview was conducted with Vanita Harris - Business office manager (S5) , and a copy of facilities’ appeal rights and this report has been provided.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 11-AS-20250513155247
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		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, LLC
FACILITY NUMBER: 198603220
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/15/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/15/2025
Section Cited
CCR
87555(b)(7)
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87555 General Food Service Requirements
(b) The following food service requirements shall apply: (7) Modified diets prescribed by a resident's physician as a medical necessity shall be provided. This has not been met as evidenced by: based on LPA's observation, interviews and record reviews in which the
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Upon identification of this deficiency, facility placed R1's physician diet orders with other residents' physician diet orders, located on the kitchen's cork board, for facility cooks to review prior to serving food items to residents in care. Furthermore, administrator and kitchen supervisor will implement a
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licensee failed to follow R1's physician diet order, which poses a potential health risk related to residents in care.
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verification log in which all diet orders will be verified within 24 hours of a resident's admission, or any dietary change(s), and a copy will be posted on the kitchen's cork board to make sure the facility is following residents' physician diet orders to remain compliant under title 22 regulation.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Mario Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2025
LIC9099 (FAS) - (06/04)
Page: 6 of 6