198320197-5-19-2025-11-AS-JHAD-DGXPDS-20250523111401

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320197
Report Date: 05/19/2025
Date Signed: 05/19/2025 01:22:48 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
05/06/2024 and conducted by Evaluator Zina Brown

COMPLAINT CONTROL NUMBER: 11-AS-20240506161638

FACILITY NAME:	PLAZA AT WESTWOOD, THE		FACILITY NUMBER:	198320197
ADMINISTRATOR:	LUZ EMMA ROSE		FACILITY TYPE:	740
ADDRESS:	2228 WESTWOOD BLVD		TELEPHONE:	(310) 475-8861
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90064
CAPACITY:	136	CENSUS: 65	DATE:	05/19/2025
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Teresa Pascual (Wellness Director)		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Staff did not accept resident back into care following hospitalization.
Staff did not treat resident with dignity or respect.
Staff left resident in soiled diapers for an extended period of time.

INVESTIGATION FINDINGS:

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On05/19/2025, at 10:39 am Licensing Program Analyst (LPA) Zina Brown conducted a subsequent visit in order to deliver investigation findings. LPA met with Teresa Pascual (Wellness Director), and explained the purpose of the visit.

The investigation consisted of the following: On 11/04/2024, LPA Brown interviewed the Administrator (A1), staff members (S1-S5), and residents (R2-R8). LPA requested the resident and staff roster, resident files for R1-R7, including Admission Agreement, Pre-Placement Appraisal, Resident Appraisal, Appraisal/ Needs and Service Plan, Unusual Serious Incident Reports, List of Incontinence Residents, Incontinence Logs (dated 08/01/2024 – 10/31/2024), and LIC 602 Physician’s Report for RCFE. LPA was not able to interview Resident #1 (R1) since the resident no longer resides at the facility and LPA was unable to locate the resident after multiple attempts.

Report continues on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 05/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2025

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-20240506161638

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: PLAZA AT WESTWOOD, THE	FACILITY NUMBER: 198320197
	VISIT DATE: 05/19/2025

NARRATIVE

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The investigation revealed the following:

Allegation 1: Staff did not accept resident back into care following hospitalization.

It was alleged that Resident #1 was refused re-admission following hospitalization. On 11/04/2024 at 9:45 AM, LPA interviewed A1, who denied the allegation, stating that R1 needed more care but was not refused re-admission. Between 11:45 AM - 1:00 PM, LPA interviewed 5 staff members regarding the allegation: 2 of 5 staff denied the allegation. 3 of 5 staff were unaware of the situation. Between 10:00 AM - 11:30 AM, LPA interviewed 7 residents: 0 out of 7 residents confirmed the allegation. 2 out of 5 residents were unsure or unaware of the situation. 5 out of 7 residents denied the allegation. LPA reviewed records and did not observe any documentation to support the allegation.

Based on interviews conducted an records reviewed there is no evidence to support the allegation, therefore the allegation is unsubstantiated.

Allegation 2: Staff left residents in soiled diapers for an extended period of time.

It was alleged that incontinent residents were not changed in a timely manner.

On 11/04/2024 at 9:45 AM, LPA interviewed A1, who denied the allegation. Between 11:45 AM - 1:00 PM, LPA interviewed 5 out of 5 staff denied the allegation. Between 10:00 AM - 11:30 AM, LPA interviewed 7 residents: 4 out of 7 residents were independent and did not require incontinence care. 3 out of 7 residents who required incontinence care denied the allegation. LPA reviewed incontinence logs and observed documentation of care being provided every two hours.

Based on interviews conducted an records reviewed there is no evidence to support the allegation, therefore the allegation is unsubstantiated.

Report continues on LIC 9099-C

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 05/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20240506161638

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: PLAZA AT WESTWOOD, THE	FACILITY NUMBER: 198320197
	VISIT DATE: 05/19/2025

NARRATIVE

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Allegation 3: Staff did not treat residents with dignity or respect.

It was alleged that staff mistreated residents. On 11/04/2024 at 9:45 AM, LPA interviewed Administrator (A1), who denied the allegation. Between 11:45 AM - 1:00 PM, LPA interviewed 5 staff: 4 out of 5 staff denied the allegation. 1 out of 5 staff acknowledged witnessing mistreatment. Between 10:00 AM - 11:30 AM, LPA interviewed 7 residents: 4 out 7 residents confirmed the allegation. 3 out of 7 residents denied the allegation. LPA reviewed records but did not observe documentation supporting the allegation.

Based on LPAs observations and interviews which were conducted and the records that were reviewed, the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be UNSUBSTANTIATED.

No citations were issued for this complaint.

An exit interview was conducted, and a hard copy of this Complaint Investigation Report was provided to Teresa Pascual, Wellness Director.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Zina Brown
LICENSING EVALUATOR SIGNATURE:	DATE: 05/19/2025

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2025

LIC9099 (FAS) - (06/04)

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