198603220-9-27-2024-11-AS-SCIS-DALV4E-20241101160613

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603220
Report Date: 09/27/2024
Date Signed: 09/27/2024 02:24:42 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, 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
09/06/2024 and conducted by Evaluator Elvira Gonzalez

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20240906101758

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: 103	DATE:	09/27/2024
		UNANNOUNCED	TIME BEGAN:	11:08 AM
MET WITH:	Mendy Ginsburg		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff locked resident inside their room.
Staff did to meet resident's dietary needs.
Staff did not allow resident to have personal food items.

INVESTIGATION FINDINGS:

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On 09/27/24 Licensing Program Analyst (LPA) Elvira Gonzalez conducted a subsequent complaint investigation at the above facility to deliver findings on the allegations listed above. LPA met with Administrator Mendy Ginsburg and explained the purpose of the visit.

The investigation consisted of the following: On 09/09/24, LPA received the Staff Roster, Client Roster, interviewed resident #1 (R1), and staff #1-#3 (S1-S3). Additionally, LPA and Venita Harris toured a portion of the facility, but due to time constraints were unable to finish the tour. On 09/19/24, LPA Gonzalez toured the facility, reviewed records, and received copies of R1’s Service Plan, Preplacement Appraisal Information, Physician’s Report, and Admission Agreement. Interviews conducted with residents #2-#7 (R2-R7), and staff #4-#7 (S4-S7). Furthermore, LPA and Administrator Mendy Ginsburg toured the entire facility. On 09/26/24 LPA reviewed the facility’s House Rules included in the Plan of Operation. Administrator Mendy Ginsburg provided a copy of the Residence and Care Agreement to LPA via email.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
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.

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20240906101758

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: 09/27/2024

NARRATIVE

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The investigation revealed the following:

Regarding the allegation "Staff locked resident inside their room,” it is alleged that the facilities Administrator Mendy Ginsburg asked to see a resident’s phone after observing a resident taking photos of other residents. When the resident refused giving up their phone, Mendy Ginsburg told the resident they would be confined to their room.

An interview conducted with Administrator Mendy Ginsburg on 09/09/24 revealed that he saw R1 taking pictures of other residents without their consent, and that is not allowed in the facility. Mendy Ginsburg denies telling R1 that they would be confined to their room as a form of punishment but told them they would not be allowed in the dining room if they were going to take pictures of other residents without their consent and violating their privacy.

An interview conducted with R1 on 09/09/24 revealed that while having dinner in the dining room, they took pictures of some residents that were eating outside food, after being told by staff that they were not allowed to bring outside food into the dining room. Mendy Ginsburg the administrator saw R1 taking pictures and asked them for their phone. R1 stated they refused to give Mendy their phone, which led to Mendy telling R1 they would be confined to their room until further notice.

On 09/09/24 LPA interviewed S2-S3, and on 09/19/24 LPA interviewed R2-R7 and S4-S7. Interviews revealed the following: 6 out of 7 staff interviewed, revealed that they were not aware of any resident being confined to their room. 6 out of 7 residents interviewed revealed that they didn’t know or had heard of any resident being confined to their room.

Based on observation, evidence gathered, interviews conducted, and records reviewed, there was not enough supportive evidence to concur with the reported allegation. 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.

Continued on LIC9099-C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
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

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20240906101758

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: 09/27/2024

NARRATIVE

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Regarding the allegation “Staff did to meet resident's dietary needs,” it is alleged that the facility does not adhere to resident’s dietary restrictions.

On 09/09/24 LPA interviewed S1-S3, and R1. On 09/19/24 LPA interviewed S2-S7 and R2-R7. 7 out of 7 staff interviewed stated that the facility always follows the resident’s dietary needs. 5 out of 7 residents interviewed revealed that the facility does meet all the resident’s dietary needs. 5 out of 7 residents interviewed stated that they are very satisfied with the services and food that is being provided to them.

Based on observation, evidence gathered, interviews conducted, and records reviewed, there was not enough supportive evidence to concur with the reported allegation. 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.

Regarding the allegation “Staff did not allow resident to have personal food items,” it is alleged that the facility does not allow any outside food into the facility.

On 09/09/24 LPA interviewed S1-S3, and on 09/19/24 LPA interviewed S4-S7. 5 out of 7 staff members interviewed indicated that the residents are allowed to bring outside food into the facility. On 09/09/24 LPA interviewed R1, and on 09/19/24 LPA interviewed R2-R7. 2 out of 7 residents interviewed stated that residents are not allowed to bring any outside food into the facility, while 5 out of 7 residents interviewed stated that they are unsure if they allowed to bring outside food into the facility.

Based on observation, interviews conducted, and records reviewed, there was not enough supportive evidence to concur with the reported allegation. 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 with Administrator Mendy Ginsburg, and a copy of this report along with appeal rights was provided.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
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

LIC9099 (FAS) - (06/04)

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