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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197610403
Report Date: 01/14/2025
Date Signed: 01/14/2025 02:51:47 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 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
08/21/2024 and conducted by Evaluator Raymond Comer
COMPLAINT CONTROL NUMBER: 31-AS-20240821100726
FACILITY NAME:GARDEN OF PALMS LAFACILITY NUMBER:
197610403
ADMINISTRATOR:HIRSCH,RENAFACILITY TYPE:
740
ADDRESS:1025 N FAIRFAX AVETELEPHONE:
(323) 656-7900
CITY:LOS ANGELESSTATE: CAZIP CODE:
90046
CAPACITY:130CENSUS: 107DATE:
01/14/2025
UNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Adam SyncheffTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Facility Staff lack the ability to communicate with residents-
Resident(s) room(s) not maintained clean, safe and sanitary at all times-
Resident(s) medical needs not met-
Staff do not consistently provide the services that meet the needs of residents-
Staff do not consistently manage incontinence needs of resident(s)-

INVESTIGATION FINDINGS:
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At 8:35 am, Tuesday, 1/14/25, Licensing Program Analyst (LPA) Raymond Comer, conducted a subsequent visit regarding the allegation listed above. LPA conducted the initial complaint visit on Thursday 8/29/24, and subsequent visit on Thursday, 09/19/24. LPA met with Administrator Adam Syncheff, and the purpose of the visit was disclosed.

At 9:00 am, LPA conducted a physical plant tour; no health and safety issues were observed.

To investigate the allegation, LPA received Facility resident roster, and staff roster. At 9:10 am, reviewed Resident files, and other documents relevant to the investigation, and conducted on-site interview with the Administrator, three (3) Staff and seven (7) Residents.

[LIC 9099C]- Continued
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
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 4
Control Number 31-AS-20240821100726
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: GARDEN OF PALMS LA
FACILITY NUMBER: 197610403
VISIT DATE: 01/14/2025
NARRATIVE
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Allegation: Staff lack the ability to communicate with residents- The Reporting Party (RP) alleges that Resident#1's (R1's) care is neglected, due to a language barrier prohibiting communication between R1 and staff caregivers.
To investigate the allegation, LPA observed staff and residents communicating in common areas of the facility, conducted interviews with three (3) staff from 9:20 am, to 11:45 am, and interviewed seven (7) residents from 12:00 pm, to 3:00 pm. Staff interviewed by LPA state they are able to communicate with residents on a level satisfactory in meeting resident needs. LPA interviews with seven (7) residents revealed the following; six (6) out of seven (7) residents state that communications between residents and staff is satisfactory in meeting resident needs.

Although this allegation may have occurred, or is valid, there is not a preponderance of evidence to prove the alleged did, or did not occur, therefore the allegation is UNSUBSTANTIATED at this time.

Allegation: Resident(s) room(s) not maintained clean, safe and sanitary at all times- The Reporting Party (RP) alleges that Resident#1's (R1's) room, and the rooms of other residents, are unsanitary, and emit foul odors.
To investigate the allegation, LPA conducted random observations of resident room(s) #104, #109, #115, #116, #202, and #208. LPA observations found resident rooms as clean, properly furnished, and not exhibiting any foul odors. LPA conducted interviews with three (3) staff from 9:20 am, to 11:45 am, and interviewed seven (7) residents from 12:00 pm, to 3:00 pm. Staff interviewed by LPA state rooms are cleaned daily by housekeeping staff. LPA interviews with seven (7) residents revealed the following; seven (07) out of seven (07) residents state that facility bedrooms are cleaned daily by staff.

Although this allegation may have occurred, or is valid, there is not a preponderance of evidence to prove the alleged did, or did not occur, therefore the allegation is UNSUBSTANTIATED at this time.

Allegation: Resident medical needs not met. -The Reporting Party (RP) alleges that Resident#1 (R1) is not provided proper hydration, a "dietetic diet", nor are R1's feet elevated.

[LIC 9099C]- Continued
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 31-AS-20240821100726
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: GARDEN OF PALMS LA
FACILITY NUMBER: 197610403
VISIT DATE: 01/14/2025
NARRATIVE
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To investigate the allegation, LPA conducted review of Resident#1's (R1's) file and other relevant documents. Per documents review, R1's feet are to be elevated, a diabetic diet provided, and a juice beverage made available. In the morning, LPA conducted an observation of R1's room, which revealed the following: R1 was found sitting in a recliner chair with feet elevated. Water and juice beverage were observed sitting on a small table next to R1's recliner chair. A small refrigerator in R1's room contained a pitcher with juice beverage. LPA interviewed three (3) staff from 9:20 am, to 11:45 am, which revealed the following: Staff are aware of R1's needs and state they fulfill care plan directives on a consistent basis. LPA interviewed seven (7) residents from 12:00 pm, to 3:00 pm. which revealed the following; six (6) out of seven (7) residents state that staff provide satisfactory care/assistance and have no concerns.

Although this allegation may have occurred, or is valid, there is not a preponderance of evidence to prove the alleged did, or did not occur, therefore the allegation is UNSUBSTANTIATED at this time.

Allegation: Staff do not consistently provide the services that meet the needs of residents. The Reporting Party (RP) alleges that staff do not check on Resident#1 (R1) often enough, neglecting R1's need for staff assistance.
To investigate the allegation, LPA conducted review of Resident#1's (R1's) file and other relevant documents, conducted interviews with three (3) staff from 9:20 am, to 11:45 am, and interviewed seven (7) residents from 12:00 pm, to 3:00 pm. Staff interviewed by LPA state that R1 is visited by staff every two hours, and sometimes more frequently if R1 appears either agitated or anxious. LPA interviews with seven (7) residents revealed the following; six (6) out of seven (7) residents state that staff provide satisfactory assistance on a consistent basis.

Although this allegation may have occurred, or is valid, there is not a preponderance of evidence to prove the alleged did, or did not occur, therefore the allegation is UNSUBSTANTIATED at this time.

Allegation: Staff do not consistently manage incontinence needs of resident(s)- The Reporting Party (RP) alleges that Resident #1 (R1) is not being changed on a timely and consistent basis.
To investigate the allegation, LPA interviewed three (3) staff from 9:20 am, to 11:45 am, and interviewed seven (7) residents from 12:00 pm, to 3:00 pm. LPA interviews with with staff revealed the following: Interviewed staff state checking on R1, and all other residents every two (02) hours, or more frequently, if needed.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 31-AS-20240821100726
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: GARDEN OF PALMS LA
FACILITY NUMBER: 197610403
VISIT DATE: 01/14/2025
NARRATIVE
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LPA interviews with seven (7) residents revealed the following: seven (7) out of seven (7) residents state visitations by staff a minimum of every two hours.

Although this allegation may have occurred, or is valid, there is not a preponderance of evidence to prove the alleged did, or did not occur, therefore the allegation is UNSUBSTANTIATED at this time.

An exit interview was conducted, and a copy of this report was provided.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Raymond Comer
LICENSING EVALUATOR SIGNATURE:

DATE: 01/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/14/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4