198320197-12-2-2025-11-AS-SCIS-DPJ3HF-20251219171552

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320197
Report Date: 12/02/2025
Date Signed: 12/02/2025 12:03:10 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
07/28/2025 and conducted by Evaluator Elvira Gonzalez

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20250728155456

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; 136	CENSUS: 63	DATE:	12/02/2025
		UNANNOUNCED	TIME BEGAN:	10:25 AM
MET WITH:	Luz Rose		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Facility staff failed to properly supervise a resident.

INVESTIGATION FINDINGS:

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On 12/02/25, LPA Gonzalez conducted an unannounced subsequent complaint visit to further investigate the above-mentioned allegation. LPA met with Administrator, Luz Rose, and explained the purpose of the visit. LPA was granted access to the facility.

The investigation consisted of the following: On 08/05/25, LPA Gonzalez requested the following documents: staff roster, and resident roster. LPA reviewed R1’s service file and requested copies of the following documents: Admission Agreement, Identification and Emergency Information, Physician’s Report, Appraisal / Needs and Services Plan, Preplacement Appraisal Information, Resident Appraisal, Advance Health Care Directive Form, email correspondence between staff and R1's responsible party, Private Attendant (PA) notes for the months of June and July 2025, and R1’s Care Plan. Additionally, LPA conducted interviews with witness #1 (W1), staff #1-#6 (S1-S6), and residents #1-#6 (R1-R6).

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025

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-20250728155456

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: 12/02/2025

NARRATIVE

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The investigation revealed the following:

Allegation: Facility staff failed to properly supervise a resident. It is being alleged that R1 is supposed to receive 16 hours of one-on-one care a day and is often left unattended. It is also being alleged that staff is sleeping while caring for R1. On 08/05/25, LPA Gonzalez conducted a review of records and revealed the following: A Care Plan for R1 notes that R1 requires total care, including feeding with aspiration precautions, and 24-hour supervision to ensure safety. A review of the facility’s Periodic Check Sheets (for the dates of 05/27/25 – 07/28/25) revealed that R1 was receiving around the clock care from facility and agency staff.

On 08/05/25, between 11:20 AM and 01:30 PM, LPA Gonzalez conducted interviews with S1-S6. Of those interviewed, 6 out of 6 staff denied the allegation. 5 out of 6 staff said that R1 has not been left unattended by staff, and 1 out of 6 staff said they did not know if R1 has been left unattended by staff. 4 out of 6 staff said that no staff has been observed sleeping in R1’s room, and 2 out of 6 staff said that staff has been observed sleeping in R1’s room. An interview with Luz Rose, Administrator, revealed that it was brought to her attention that a staff member was observed sleeping in R1’s room while they were supposed to be caring for them. Luz Rose said that the caregiver in question was from an agency and not one of her caregivers at the facility. Furthermore, Luz Rose said they handled this matter immediately after becoming aware of it, and said the facility is no longer dealing with that agency.

On 08/05/25, between 01:40 PM and 03:00 PM, LPA Gonzalez conducted interviews with R1-R6. Of those interviewed, 6 out of 6 residents could not corroborate with the allegation. 6 out of 6 residents said they are receiving assistance as needed from staff. 6 out of 6 residents said facility staff are meeting their needs as far as care. 5 out of 6 residents said they are receiving the services they signed up for, and 1 out of 6 residents said they sometimes receive the services they signed up for. 5 out of 6 residents said they are happy with the care and supervision the staff is providing them, and 1 out of 6 residents was unable to answer due to intense emotional distress.

Continued on LIC9099-C

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20250728155456

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: 12/02/2025

NARRATIVE

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On 08/05/25, LPA Gonzalez and Theresa Pascual toured the facility and inspected R1’s bedroom #320. LPA observed R1 laying down on their bed and watching TV. LPA observed a caregiver sitting on the chair next to R1 and engaging and caring for the resident. LPA observed R1’s room to be clean and sanitary.

Based on observation, interviews conducted, and a review of records, the Department found no evidence to support the allegation mentioned above. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, as a result, the allegation is unsubstantiated.

No deficiencies were cited during this investigation.

An exit interview was conducted, and a copy of this report was provided to Administrator, Luz Rose.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025

LIC9099 (FAS) - (06/04)

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