<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 565801541
Report Date: 10/12/2021
Date Signed: 10/13/2021 08:41:27 AM

Substantiated


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. #250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/07/2021 and conducted by Evaluator Joann Rosales
PUBLIC
COMPLAINT CONTROL NUMBER: 29-AS-20211007151918
FACILITY NAME:FINEST LIVING AT CRESTWOODFACILITY NUMBER:
565801541
ADMINISTRATOR:ADELAIDA G. CRUZFACILITY TYPE:
740
ADDRESS:225 CRESTWOOD AVENUETELEPHONE:
(805) 212-8303
CITY:VENTURASTATE: CAZIP CODE:
93003
CAPACITY:6CENSUS: 6DATE:
10/12/2021
UNANNOUNCEDTIME BEGAN:
09:56 AM
MET WITH:Adelaida CruzTIME COMPLETED:
03:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility does not have operable smoke detectors in resident rooms
Facility did not obtain a permit from the City for kitchen remodel
Facility failed to provide adequate food service
Resident room smelled of urine
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) JoAnn Rosales conducted a complaint investigation visit. LPA met with Administrator Adelaida Cruz.

During today's visit LPA toured the facility with staff Alex Garcia, interviewed staff and residents, reviewed resident records and obtained copies of pertinent documents. Concerns were that resident rooms had inoperable smoke detectors. During facility tour with staff Garcia starting at 10:06 am LPA observed a smoke detector in resident #1 (R1)'s room hanging by the wiring from the ceiling. Staff stated that the smoke detector has not been working for 2 weeks and needs a battery. During facility tour at 10:23 am with staff Garcia LPA observed a smoke detector in R2's room hanging by the wiring from the ceiling. R2 stated that when they moved into the facility that is how the smoke detector was. Staff Garcia tested all smoke detectors which are hired wired and they were all operational however, the smoke detector in R1's room was chirping due to battery needing to be replaced. Staff replaced the battery however, the smoke detector continued
Continued on 9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Joann Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2021
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 29-AS-20211007151918
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364
FACILITY NAME: FINEST LIVING AT CRESTWOOD
FACILITY NUMBER: 565801541
VISIT DATE: 10/12/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
to chirp. Concerns were that the facility did not obtain a permit from the City for kitchen remodel. During facility tour starting at 9:59 am with staff Garcia LPA observed kitchen entrance with plastic sheeting taped to the wall and kitchen completely empty with no cabinets or appliances. Staff Garcia stated that the boxes located in the dining area were the kitchen cabinets that arrived yesterday. Administrator stated at 11:31 am that Code Enforcement was at the facility last week and asked for permits for the kitchen remodel. Administrator stated that their contractor is getting the permits. Administrator stated that they were not aware that they needed to have permits for the kitchen remodel. Concerns were that the facility failed to provide adequate food service as there is no kitchen for food preparation. During facility tour starting at 10:32 am LPA observed a propane stove in the backyard where staff Alicia Resolme was cooking food in pots with lids. LPA also observed staff cutting onions on a cutting board sitting on a backyard table. LPA observed staff leave the cut onions on the cutting board and flies around the area. Administrator stated at 11:35 am that they will prepare meals inside instead of outside the facility. Concerns were that a resident room smelled like urine. While testing smoke detector in R3's room at 11:28 am LPA observed a strong smell of urine. Staff Garcia stated that the resident empties their urine bag in a commode chair in their room and they check it every 2 hours. Interview with R3 revealed that they do have a pendant to press for assistance however they do not smell the urine as their sense of smell is gone.

Based on the information obtained during the course of the investigation the allegations are deemed substantiated at this time.

Pursuant to Title 22 of the CA Code of Regulations, the following deficiencies were cited (refer to LIC 9099-D).

Civil penalty assessed in the amount of $500.00.

Exit interview conducted. Today's reports, civil penalty and appeal rights were reviewed and emailed to the Administrator.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Joann Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 29-AS-20211007151918
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: FINEST LIVING AT CRESTWOOD
FACILITY NUMBER: 565801541
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/12/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/12/2021
Section Cited
CCR
87203
1
2
3
4
5
6
7
87203 Fire Safety. All facilities shall be maintained in conformity with the regulations adopted by the State Fire Marshal for the protection of life and property against fire and panic.


This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Staff replaced smoke detector in R1's bedroom during facility visit.
8
9
10
11
12
13
14
Based on LPA's observations, the licensee did not comply with the section cited above as smoke detector in R1's room was inoperable which poses an immediate safety risk to persons in care.
8
9
10
11
12
13
14
Type B
10/25/2021
Section Cited
CCR
87305(a)
1
2
3
4
5
6
7
Alterations to Existing Building or New Facilities. Prior to construction or alterations, all facilities shall obtain a building permit.




This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Administrator stated that she will submit a building permit for kitchen remodel to CCL by 10/25/21.
8
9
10
11
12
13
14
Based on LPA's observations, the licensee did not comply with the section cited above as the kitchen cabinets and appliances were all removed from the kitchen which poses a potential safety and personal rights risk to persons in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Joann Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 29-AS-20211007151918
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: FINEST LIVING AT CRESTWOOD
FACILITY NUMBER: 565801541
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/12/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/22/2021
Section Cited
CCR
87555(b)(15)
1
2
3
4
5
6
7
87555 General Food Service Requirements(b)(15) All persons engaged in food preparation and service shall observe personal hygiene and food services sanitation practices which protect the food from contamination.


This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Administrator stated that they will have staff prepare meals inside the facility away from insects. Administrator stated that they will provide documentation of staff food service training to CCL by 10/22/21.
8
9
10
11
12
13
14
Based on LPA’s observations, the licensee failed to ensure that staff were preparing food inside the facility which poses a potential health risk to persons in care.
8
9
10
11
12
13
14
Type B
10/18/2021
Section Cited
CCR
87303(a)
1
2
3
4
5
6
7
87303 Maintenance and Operation. (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.

This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Administrator stated that they will have staff empty R3's commode chair more frequently to avoid urine smell in R3's room.
8
9
10
11
12
13
14
Based on LPA’s observations, the licensee failed to ensure that staff were emptying R3's commode chair frequently to avoid urine smell which poses a potential personal rights risk to persons in care.
8
9
10
11
12
13
14
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Kristin Heffernan
LICENSING EVALUATOR NAME: Joann Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 10/12/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 4