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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565850111
Report Date: 05/24/2021
Date Signed: 05/24/2021 06:55:14 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/21/2021 and conducted by Evaluator Martha Guzman-Chavez
PUBLIC
COMPLAINT CONTROL NUMBER: 29-AS-20210521142052
FACILITY NAME:LEXINGTON ASSISTED LIVINGFACILITY NUMBER:
565850111
ADMINISTRATOR:SANJUANA ENRIQUEZFACILITY TYPE:
740
ADDRESS:5440 RALSTON STTELEPHONE:
(805) 644-6710
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY:125CENSUS: 75DATE:
05/24/2021
UNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Matteo DigrigoliTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Food is not nutritionally adequate.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Kelly Dulek and Martha Guzman Chavez initiated a complaint investigation for the allegations listed above at 1:20 PM. LPAs Dulek, and Guzman Chavez initally met with Operations and Marketing Director Matteo Digrigoli and Wellness Director Lidia Padilla and discussed the reason for today's visit. Entrance interview conducted.
LPAs interviewed the Operations and Marketing Director ans Welnness Director at 1:26 PM, conducted a physical plant tour at 1:49 PM, a kitchen and dining area tour at 2:05 PM, and conducted resident interviews between 2:52PM and 3:25 PM. While conducting the walkthrough, both the pantry and the walk-in freezer were observed to have sifficient food for the entire facility. As well as food from all different food groups. Food labels were inspected and checked to verify they were up to date and not expired. Food labels had expiration date clearly marked as well as having the nutrition facts label in tact. Resident interviews revealed there is a wide variety of foods offered from all food groups. All 4 of 4 residents interviewed are happy with the food and stated that the food is of good quality and quantity. CONT on 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Martha Guzman-ChavezTELEPHONE: (818) 596-4334
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2021
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 3
Control Number 29-AS-20210521142052
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: LEXINGTON ASSISTED LIVING
FACILITY NUMBER: 565850111
VISIT DATE: 05/24/2021
NARRATIVE
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Based off the information obtained during the investigation, there was insufficient evidence to support the claim that the food is nutritionally inadequate. This allegation is deemed Unsubstantiated at this time.

Exit interview conducted. A copy of the report was provided via email.
SUPERVISOR'S NAME: Desaree PereraTELEPHONE: (818) 596-4347
LICENSING EVALUATOR NAME: Martha Guzman-ChavezTELEPHONE: (818) 596-4334
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3