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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306005199
Report Date: 10/26/2023
Date Signed: 10/26/2023 11:28:58 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/25/2021 and conducted by Evaluator Kimberly Lyman
COMPLAINT CONTROL NUMBER: 22-NP-20210625072735
FACILITY NAME:COTTAGES AT ARTESIA GARDENS, THEFACILITY NUMBER:
306005199
ADMINISTRATOR:AURELIA OLAISFACILITY TYPE:
740
ADDRESS:6041 KINGMAN AVETELEPHONE:
(800) 570-2273
CITY:BUENA PARKSTATE: ZIP CODE:
90621
CAPACITY:0CENSUS: 48DATE:
10/26/2023
UNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Aurelia OlaisTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Facility allowed unauthorized access to resident's facility files
Facility gave direction to give out false information to authorities
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Kimberly Lyman conducted an unannounced complaint visit to deliver findings on the above allegations. LPA was greeted and granted entry into the facility and explained the reason for the visit.
During the course of the investigation, LPA toured the facility, interviewed staff and witnesses as well as reviewed and obtained pertinent documentation such as facility notes. Regarding the allegations that facility allowed unauthorized access to resident's facility files and facility gave direction to give out false information to authorities, the investigation revealed the following: Four out of four witnesses interviewed stated they were asked to switch to facility's hospice company, Green Meadows, and five out of five staff deny attempting to change resident's hospice companies and indicated the families all have a choice in the matter. Hospice nurse denies attempting to change hospice companies to facility company. Review of facility documents indicate facility currently works with seven other hospice companies and at time of complaint filing, six hospice companies. Five out of five staff and Home Health nurse deny allowing unauthorized access to resident's files. CONTINUED ON LIC 9099C DATED 10/26/2023
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly LymanTELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023
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 2
Control Number 22-NP-20210625072735
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868
FACILITY NAME: COTTAGES AT ARTESIA GARDENS, THE
FACILITY NUMBER: 306005199
VISIT DATE: 10/26/2023
NARRATIVE
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Staff indicate files are secured due to privacy. Five out of five staff deny the directive of lying to state licensing when they are on-site. Due to conflicting information, LPA is unable to corroborate the allegations. Based on interviews conducted and records reviewed, the allegations are deemed unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. An exit interview was conducted with and a copy of this report was provided to facility.
SUPERVISOR'S NAME: Alisa OrtizTELEPHONE: (714) 703-2855
LICENSING EVALUATOR NAME: Kimberly LymanTELEPHONE: (714) 795-1497
LICENSING EVALUATOR SIGNATURE:

DATE: 10/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2