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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610191
Report Date: 01/17/2023
Date Signed: 01/17/2023 03:01:37 PM

Unfounded


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., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/09/2023 and conducted by Evaluator Joscelyn Martinez
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20230109141320
FACILITY NAME:GARDENS AT NORTHRIDGE, THEFACILITY NUMBER:
197610191
ADMINISTRATOR:GENA GRUNDEISFACILITY TYPE:
741
ADDRESS:17650 WEST DEVONSHIRE STREETTELEPHONE:
(818) 886-1616
CITY:NORTHRIDGESTATE: CAZIP CODE:
91325
CAPACITY:135CENSUS: 79DATE:
01/17/2023
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Gena Grundeis TIME COMPLETED:
03:05 PM
ALLEGATION(S):
1
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9
Staff left a resident unattended at the hospital
INVESTIGATION FINDINGS:
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2
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9
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13
On 01/17/22 Licensing Program Analyst (LPA) Joscelyn Martinez arrived at the facility to conduct an unannounced complaint visit. Upon arrival LPA met with administrator Gena Grundeis and the purpose of the visit was explained.

Allegation: Staff left a resident unattended at the hospital
Upon investigation of the allegation it was revealed that resident resides in the skilled nursing facility of Gardens at Northridge and not a part of assisted living nor memory care licensed by Department of Social Services Community Care Licensing. The skilled nursing is located on the same property of Gardens at Northridge. LPA interviewed staff at the skilled nursing facility located on the same grounds and confirmed resident is currenlty admitted in skilled nursing. Therefore, based on interviews this allegation is deemed Unfounded, meaning that the allegation was false, could not have happened and/or is without a reasonable basis.
Exit interview conducted. Report signed and delivered.
Unfounded
Estimated Days of Completion:
SUPERVISORS NAME: Nichelle Gillyard
LICENSING EVALUATOR NAME: Joscelyn Martinez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2023
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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