Inspection Reports for My Mother’s Place Mar Vista
11827 Rose Ave, Los Angeles, CA 90066, United States, CA, 90066
Back to Facility ProfileDeficiencies per Year
8
6
4
2
0
Severe
High
Moderate
Low
Unclassified
Census Over Time
Census
Capacity
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 6
Oct 22, 2025
Visit Reason
An unannounced annual inspection was conducted to evaluate compliance with licensing requirements for the facility.
Findings
The inspection found missing staff files, broken locks on medication cabinets and knife drawers, inaccessible bedroom door, and missing required documentation in resident files. The facility was otherwise clean and in good repair with adequate food supplies. A continuation inspection is planned due to insufficient time to complete the review.
Deficiencies (6)
| Description |
|---|
| Staff files were not available for review during the inspection. |
| Broken lock on the kitchen cabinet where medications are stored. |
| Broken drawer where knives/sharps are stored. |
| Bedroom at the front door could not be opened during the inspection. |
| Missing required documentation, service plans, or current physicians’ reports in resident files. |
| LIC610D form was not observed or provided during the inspection. |
Report Facts
Capacity: 6
Census: 4
Food supply duration: 5
Food supply duration: 7
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Hilda Lozano | Administrator | Named in relation to staff file availability and inspection findings |
| Gabriela Torreblaca | Support Staff | Met with Licensing Program Analyst and participated in inspection |
| Bernadette Allen | Licensing Program Analyst | Conducted the inspection |
| Rosa Pioquinto | Assisted in touring the facility during inspection |
Inspection Report
Complaint Investigation
Capacity: 6
Deficiencies: 0
Mar 21, 2025
Visit Reason
The inspection was conducted as an unannounced complaint investigation following an allegation that staff did not dispense medication to a resident as prescribed by a physician.
Findings
The investigation included interviews with staff and residents, review of medication records, and observations. All interviewed staff and residents denied the allegation, and medication levels for the resident were verified as normal. The allegation was deemed unsubstantiated due to insufficient evidence.
Complaint Details
Allegation: Staff did not dispense medication to resident as prescribed by physician. The allegation was found unsubstantiated after investigation including interviews and record reviews.
Report Facts
Facility capacity: 6
Staff interviewed: 4
Residents interviewed: 4
Medication administration frequency: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Hilda Lozano | Administrator | Greeted Licensing Program Analyst and participated in investigation |
| Troy Watson | Licensing Program Analyst | Conducted the complaint investigation |
| Stephanie Cifuentes | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Complaint Investigation
Census: 5
Capacity: 6
Deficiencies: 0
Feb 12, 2025
Visit Reason
An unannounced complaint investigation was conducted to investigate the allegation that staff did not dispense medication to a resident as prescribed by the physician.
Findings
The investigation included interviews with staff and residents, review of medication records, and observations. The allegation was found to be unsubstantiated due to insufficient evidence to support the claim.
Complaint Details
The complaint alleged that staff did not dispense medication to a resident as prescribed by the physician. Interviews with 4 staff members and 4 residents all answered no to the allegation. Medication records for resident #1 showed medication was administered as prescribed and verified by blood tests. The allegation was deemed unsubstantiated.
Report Facts
Capacity: 6
Census: 5
Staff interviewed: 4
Residents interviewed: 4
Medication administration frequency: 3
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Hilda Lozano | Administrator | Met with Licensing Program Analyst during investigation and named in report |
| Troy Watson | Licensing Program Analyst | Conducted the complaint investigation |
| Stephanie Cifuentes | Licensing Program Manager | Named as Licensing Program Manager on report |
Inspection Report
Follow-Up
Census: 3
Capacity: 6
Deficiencies: 0
Nov 13, 2024
Visit Reason
The visit was an unannounced Plan of Correction (POC) inspection to ensure that deficiencies cited during the annual inspection on 2024-11-07 were corrected and in compliance with Title 22 Regulations.
Findings
The Licensing Program Analyst observed all previously cited deficiencies related to personnel records, incidental medical and dental care, resident records, and emergency plans were corrected with no deficiencies found during this visit.
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Perry Scott | Licensing Program Analyst | Conducted the unannounced POC visit and observed corrections of deficiencies. |
| Hilda Lozano | Administrator | Facility Administrator met with the Licensing Program Analyst during the visit. |
| Janae Hammond | Licensing Program Manager | Named as Licensing Program Manager on the report. |
Inspection Report
Annual Inspection
Census: 3
Capacity: 6
Deficiencies: 5
Nov 7, 2024
Visit Reason
The visit was an unannounced required annual inspection of the facility using the new Care Tool to assess compliance with regulations.
Findings
The facility was generally clean, appropriately furnished, and maintained with adequate supplies and safety equipment. However, multiple deficiencies were cited due to the licensee's failure to make facility records available for review, posing potential health, safety, or personal rights risks to residents.
Severity Breakdown
Type B: 5
Deficiencies (5)
| Description | Severity |
|---|---|
| Personnel records were not maintained or available for review upon annual inspection. | Type B |
| Incidental medical and dental care service records, including medication dosage records, were not available for review. | Type B |
| Resident records were not available for review upon annual inspection. | Type B |
| Facility did not conduct or document emergency drills as required. | Type B |
| Facility did not have required emergency information readily available to staff, including resident roster with dates of birth and resident medication lists. | Type B |
Report Facts
Facility capacity: 6
Current census: 3
Fire extinguisher last inspection date: Aug 22, 2024
Water temperature: 108.5
PPE supply duration: 90
Plan of Correction due date: Nov 21, 2024
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Perry Scott | Licensing Program Analyst | Conducted the inspection and authored the report |
| Janae Hammond | Licensing Program Manager | Supervisor overseeing the inspection |
| Rosa Pioquinto | Staff | Facility staff member who met with the Licensing Program Analyst during the inspection |
Inspection Report
Annual Inspection
Census: 4
Capacity: 6
Deficiencies: 2
Nov 6, 2023
Visit Reason
An unannounced annual required visit was conducted to My Mother's Place Facility to evaluate compliance with licensing regulations.
Findings
The facility was generally clean, odor-free, and in good repair with adequate safety measures in place. However, deficiencies were cited for a non-operational oven and lack of staff CPR certification.
Deficiencies (2)
| Description |
|---|
| The stove in the facility does not work which poses a potential health, safety or personal rights risk to persons in care. |
| Licensee did not ensure that staff is certified and trained in CPR which poses a potential health, safety or personal rights risk to persons in care. |
Report Facts
Capacity: 6
Census: 4
Plan of Correction Due Date: Nov 20, 2023
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Hilda Lozano | Administrator | Met with Licensing Program Analyst during inspection and received report |
| Felisa Shirley | Licensing Program Analyst | Conducted the inspection and authored the report |
| Stephanie Cifuentes | Licensing Program Manager | Supervisor overseeing the inspection |
Inspection Report
Annual Inspection
Census: 5
Capacity: 6
Deficiencies: 0
Nov 19, 2021
Visit Reason
An unannounced annual required visit was conducted to My Mother's Place Facility with emphasis on infection control, including review of client records, staff records, medications, and inspection of the entire facility.
Findings
The facility was found to be clean, odor-free, and in good repair with no deficiencies cited. All client rooms, bathrooms, and safety equipment were inspected and found compliant with regulations.
Report Facts
Fire extinguishers: 3
Residents present: 5
Licensed capacity: 6
Water temperature: 105
Employees Mentioned
| Name | Title | Context |
|---|---|---|
| Ngozi Nwaokoro | Licensing Program Analyst | Conducted the inspection |
| Hilda Lozano | Administrator | Facility administrator met during inspection |
| Michael Cava | Licensing Program Manager | Named in report header |
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