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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320197
Report Date: 10/17/2025
Date Signed: 10/17/2025 01:34:27 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
10/10/2025 and conducted by Evaluator Jose Calderon
COMPLAINT CONTROL NUMBER: 11-AS-20251010121004
FACILITY NAME:PLAZA AT WESTWOOD, THEFACILITY NUMBER:
198320197
ADMINISTRATOR:LUZ EMMA ROSEFACILITY TYPE:
740
ADDRESS:2228 WESTWOOD BLVDTELEPHONE:
(310) 475-8861
CITY:LOS ANGELESSTATE: CAZIP CODE:
90064
CAPACITY:136CENSUS: 63DATE:
10/17/2025
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:ADMINISTRATOR EMMA LUZTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff did not address a resident's change in medical condition
INVESTIGATION FINDINGS:
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On 10/17/2025 Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced visit to The Plaza at Westwood and was greeted by Administrator Emma Luz (S1). LPA Calderon explained the purpose of this visit is to deliver the findings pertaining to the above-mentioned allegation.

The investigation consisted of the following: LPA Calderon interviewed Staff S1-S4, resident R1-R6. LPA Calderon obtained the following records: Email from resident family members (dated 10/09/2025), Incident report (dated 10/05/2025), Physician Report (dated 01/31/2025), Needs and Service Plan (dated 04/30/2025), UCLA Medical Center (dated 10/03/2025) for R1.

The investigation revealed the following:
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2025
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 2
Control Number 11-AS-20251010121004
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: 10/17/2025
NARRATIVE
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Regarding the Allegation: Staff did not address the residents’ change in medical conditions.

This complaint alleged that the facility staff did not update R1 medical condition. LPA Calderon noted staff serving breakfast to residents. LPA Calderon witnessed staff moving residents with no issues and there were no negative interactions. Reviewed incident report (dated 10/05/2025), report indicates that R1 had an unwitnessed fall and was taken to the hospital. The report does suggest that R1 family was advised of the incident. The Physician Report (dated 01/31/2025) and Needs and Service Plan (dated 04/30/2025) indicates that R1 lives independent life and has cognitive issues. UCLA Hospital report (dated 10/03/2025) indicates that R1 was evaluated for skin tears to the right forearm falling out of bed. 4 out of 4 staff deny the allegation. R1 cannot be interviewed due to not being in the facility. 5 out of 6 residents deny the allegation.

Based on interviews and supporting documentation, the preponderance of evidence standard has NOT been met therefore, the allegation of “staff did not address a residents change in medical condition” is found to be UNSUBSTANTIATED.

No deficiencies cited during today's visit.



An exit interview was conducted, and a copy of the Complaint Report was provided to the Administrator Emma Luz (S1).
SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Calderon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2