198603220-11-15-2023-11-AS-SCIS-CYBVZ7-20231208155213

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603220
Report Date: 11/15/2023
Date Signed: 11/15/2023 01:11:17 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 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
10/12/2023 and conducted by Evaluator Felisa Shirley

COMPLAINT CONTROL NUMBER: 11-AS-20231012154658

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: 80	DATE:	11/15/2023
		UNANNOUNCED	TIME BEGAN:	12:26 PM
MET WITH:	Mendy Ginsburg, Director		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff spoke inappropriately to a resident

INVESTIGATION FINDINGS:

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On 11/15/23, Licensing Program Analyst (LPA) Felisa Shirley conducted an unannounced subsequent visit to this facility. LPA was met by Director, Mendy Ginsburg, and explained the purpose of the visit is to deliver findings for the allegations mentioned above and was granted access to the facility.

The investigation consisted of the following:

On 10/18/23 LPA reviewed resident files and toured the facility. LPA reviewed and requested copies of the following records: Client Roster, Staff Roster, resident files and admissions agreements.

The investigation revealed the following:

Cont'd 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Felisa Shirley	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023

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-20231012154658

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: CITY VIEW LA, LLC	FACILITY NUMBER: 198603220
	VISIT DATE: 11/15/2023

NARRATIVE

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Allegation: Staff spoke inappropriately to a resident

On 10/18/23 LPA conducted interviews with both staff and residents. LPA Shirley reviewed facility files. During file review, found there to be no evidence of harassment, nor write ups for mistreatment of clients in care. LPA interviewed all staff, staff 1 – staff 8 (S-1 – S-8). LPA asked if staff speak to residents inappropriately. Of those interviewed 8 out of 8 stated no. LPA interviewed residents 1 – resident 8 (R-1 – R-8). LPA asked residents, if staff yelled at them or spoke to them inappropriately. Of those interviewed, 7 out of 8 answered, No.

Based on information gathered, the department did not find sufficient evidence to support allegations "Staff spoke inappropriately to a resident.” 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, therefore the allegation is unsubstantiated.

An exit interview was conducted and a copy of the LIC 9099 was provided to Director Mendy Ginsburg.

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Felisa Shirley	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 11/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2023

LIC9099 (FAS) - (06/04)

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