Veterans Home Of California - West Los Angeles

On 5/23/2025 at approximately 8:30 AM, LPA Alfonso Iniguez conducted an unannounced complaint visit. LPA Iniguez met with Marnell Banks/Resident Care Specialist. LPA Iniguez explained the purpose of this visit. Investigation Consisted of: LPA Iniguez conducted the following interviews: Resident Care Specialist (A#1), Standards and Compliance Manager (S#1) and Residents Interviews (R#1-R#7). LPA obtained and reviewed the following documents: Resident Roster dated: 5/23/25 and Personnel Report or LIC 500 dated:5/23/2025. Evaluation Report continues LIC 9099-C Unfounded— CDSS inspection report, May 23, 2025 · control 11-AS-20250522115831

On February 4, 2025, Community Care Licensing Department staff Deborah Lee conducted an unannounced complaint visit to the address the allegation listed above. The department staff was greeted by the Standars and Compliance Manager Aithi Hong, who granted access to the facility and the purpose of the visit was discussed. This complaint alleges that Resident 1(R1) passed away on 1/23/25 at 9:30am and his body was placed in trailer generally used to store food in case of an emergency. R1’s body was allegedly picked up approximately 8:00pm from the loading dock where the trailers are located. The investigation consisted of the following: The department staff conducted a tour of facility both inside and out, made observation of food service and storage areas including the loading dock, reviewed resident rosters (dated 1/23/25 and 2/4/25), and interviews conducted with 3 staff (S1- S3) and the Standard and Compliance mnager (A1). Page 1 of 2 UnsubstantiatedRead the full finding— CDSS inspection report, February 4, 2025 · control 11-AS-20250131114522

On 03/28/24, at 10:00am, Licensing Program Analyst (LPA) Perry Scott conducted a 10-day complaint visit to the facility and was greeted by Teresa Starks, Deputy Administrator. LPA explained the purpose of this visit is to gather information about the complaint and deliver findings for the allegations mentioned above. The investigation consisted of the following: LPA investigated the allegations mentioned in this complaint; and conducted interviews with staff (S1-S4) and residents (R1-R11). Resident Roster, Staff Roster, Admission Agreement, Code of Conduct Violations, ID/Emergency Information, & Care Plan Report for R1 were obtained from the facility. The investigation revealed the following: Allegation #1- Facility staff did not notify residents' physician about changes in residents' condition while in care. Report continued on LIC9099-C UnsubstantiatedRead the full finding— CDSS inspection report, March 28, 2024 · control 11-AS-20240321143310

On 12/01/2023 at 08:00 am Licensing Program Analyst (LPA) David España conducted an initiated a 10-day complaint investigation follow-up visit for the allegation listed above. Upon arriving at the facility, LPA met with S#1 and S#2 who assisted with the visit. The purpose of today’s visit was discussed. Upon arrival at the facility, LPA conducted a risk assessment at the front door. Based on the assessment, the facility is clear of Covid-19 infection. LPA was granted access and allowed to enter the facility to conduct inspections. The investigation consisted of the following: On 12/01/2023 at 08:00 am LPA España conducted a tour of facility plant with S#1. LPA reviewed resident records of Seven (7) out of Fifty-Nie (59) residents to ensure it was separate, complete, and current which are maintained for each resident in the facility or in a central administrative location readily available to facility staff and to licensing. LPA España confirmed there are 59 residents. LPA España confirRead the full finding— CDSS inspection report, December 1, 2023 · control 11-AS-20231114150236

On 06/14/23, Licensing Program Analyst (LPA), Perry Scott initiated a 10-day complaint investigation at the facility listed above. LPA Scott met with Supervising Registered Nurse, Julius Lozano and explained the purpose of today’s visit was to investigate the allegations listed above. On 06/14/23, the investigation consisted of the following: During today's visit LPA conducted a health & safety check of the facility. LPA conducted interviews with the staff (S1- S3), and residents (R1 & R2). LPA requested and obtained copies of the following documents: Resident and staff roster, eviction notice for R1, ID/Emergency information, admission agreement, code of conduct agreement, Interdisciplinary Team meeting note, and eviction procedures. The investigation revealed the following: Allegation # 1 Wrongful eviction. Report continued on LIC9099-C UnsubstantiatedRead the full finding— CDSS inspection report, September 19, 2023 · control 11-AS-20230606142622

On 08/23/2023, at 8:05 AM Licensing Program Analyst (LPA) David España met with Teresa Starks, Administrator and Julius Lozano, Supervising Registered Nurse to conduct a complaint investigation to address the allegations listed above. LPA España met with Teresa Starks, Julius Lozano and explained the purpose of this visit. The investigation consisted of the following: LPA España reviewed records and documents concerning the needs further investigation. LPA España reviewed the interviews of 6 staff, 6 out of 61 residents, and reviewed the following documents: client roster, staff roster, residents R1 and R2's records which included admission agreements and eviction notices. UnsubstantiatedRead the full finding— CDSS inspection report, August 23, 2023 · control 11-AS-20230815144902

On 08/22/2023, at 9:05 AM Licensing Program Analyst (LPA) David España and Licensing Program Manager (LPM) Ulysses Coronel met with Teresa Starks, Administrator and Julius Lozano, Supervising Registered Nurse to conduct a complaint investigation to address the allegations listed above. LPA España and LPM Coronel met with Teresa Starks, Julius Lozano and explained the purpose of this visit. The investigation consisted of the following: LPA España and LPM Coronel conducted a tour of the facility grounds. LPA España and LPM Coronel interviewed 6 staff, 6 out of 61 residents, and reviewed the following documents: client roster, staff roster, residents R1 and R2's records which includes admission agreements and eviction notices. The investigation revealed the following: Regarding the allegation: "Illegal Eviction" During record review of the timeline of events indicated in R1's 3-day eviction notice, LPA and LPM did not observe reasons indicating that R1 was engaging in a behavior which posRead the full finding— CDSS inspection report, August 22, 2023 · control 11-AS-20230815144902

On 05/25/23 Licensing Program Analyst (LPA) Perry Scott conducted a continuation complaint investigation for the allegation listed above, that was initially conducted on 11/01/2022 by LPA Troy Agard. LPA met with Teresa Starks, Deputy Administrator, and explained the purpose of this visit is to deliver findings. The investigation consisted of the following: On 11/01/2022 LPA Agard toured the facility grounds for the main building of the Residential Care Facility for the Elderly (RCFE). The RCFE facility consists of 2 floors, including 34 double rooms and 16 single rooms, a total of 50 bathrooms, a bathing room, barbershop, activity room, dining room, 4 dens and a kitchen. LPA interviewed staff, residents, a witness, and reviewed records. LPA Agard requested documents, which were received at the time of visit. The investigation revealed the following: Regarding allegation #1: Residents have access to sharp objects. It’s being alleged that a resident had access to and pulled a pair of scRead the full finding— CDSS inspection report, May 25, 2023 · control 11-AS-20221025163930

On 05/25/23 Licensing Program Analyst (LPA) Perry Scott conducted a continuation complaint investigation for the allegations listed above, that was initially conducted on 11/01/2022 by LPA Troy Agard. LPA met with Teresa Starks, Deputy Administrator, and explained the purpose of this visit is to deliver findings. The investigation consisted of the following: On 11/01/2022 LPA Agard toured the facility grounds for the main building of the Residential Care Facility for the Elderly (RCFE). The RCFE facility consists of 2 floors, including 34 double rooms and 16 single rooms, a total of 50 bathrooms, a bathing room, barbershop, activity room, dining room, 4 dens and a kitchen. LPA interviewed staff, residents, a witness, and reviewed records. LPA Agard requested documents, which were received at the time of visit. The investigation revealed the following: Regarding allegation #1: Facility staff are not providing a safe environment for residents in care. Report continued on LIC9099-C UnsubsRead the full finding— CDSS inspection report, May 25, 2023 · control 11-AS-20221101132438

On 4/24/23 at 9:30 am, Licensing Program Analyst (LPA) Perry Scott conducted a complaint visit to the above facility. LPA was met by Julian Manalo, Administrator, and the purpose of the visit was explained. The investigation consisted of the following: On 4/24/23, LPA interviewed the administrator, Julian Manalo, staff 1 (S1) and S2-S4, and residents R1-R5. Additionally, LPA obtained copies of resident/staff rosters. The investigation revealed the following: Allegation- Facility dining rooms are not thoroughly being cleaned in between services Report continued on LIC9099-C Substantiated— CDSS inspection report, April 24, 2023 · control 11-AS-20230418140750

On 2/03/23 at 9:30 am, Licensing Program Analysts (LPA) Perry Scott, Lizeth Villegas, and Licensing Program Manager (LPM) Janae Hammond conducted a complaint visit to the above facility. LPAs and LPM was met by Julian Manalo, Administrator, and the purpose of the visit was explained. The investigation consisted of the following: On 2/03/23 at 10:00am, LPA interviewed the administrator, Julian Manalo, staff 1 (S1) and Staff 2-4 and residents 1-6. LPA obtained copies of resident/staff rosters, a copy of residents # 1 file which included (admission agreement, face sheet, code of conduct, eviction notice, and supporting documents). The investigation revealed the following: Allegation 1 Illegal Eviction Continued on LIC9099-C SubstantiatedRead the full finding— CDSS inspection report, February 3, 2023 · control 11-AS-20230124090434