191221839-9-14-2023-31-AS-NMAN-CWKPCB-20231013111140

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191221839
Report Date: 09/14/2023
Date Signed: 09/14/2023 04:47:34 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/07/2023 and conducted by Evaluator Rosaura Valenzuela

COMPLAINT CONTROL NUMBER: 31-AS-20230907153007

FACILITY NAME:	BROADVIEW RESIDENTIAL CARE CENTER		FACILITY NUMBER:	191221839
ADMINISTRATOR:	BETSY K DAVIS		FACILITY TYPE:	740
ADDRESS:	535 WEST BROADWAY		TELEPHONE:	(818) 246-4951
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91204
CAPACITY:	180	CENSUS: 68	DATE:	09/14/2023
		UNANNOUNCED	TIME BEGAN:	11:04 AM
MET WITH:	Betsy Davis, Administrator		TIME COMPLETED:	04:35 PM

ALLEGATION(S):

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Facility staff did not arrange a reappraisal meeting.

Facility staff restrained a resident in care.

Facility staff handle residents in a rough manner.

Facility staff do not dispense medications according to physician's orders.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rosaura Valenzuela conducted an unannounced visit for the above noted allegations. LPA met with Administrator Betsy Davis and explained the purpose of the visit.

It was reported that staff did not arrange for a reappraisal meeting. To investigate this allegation on 9/14/2023 between 12:00pm and 12:30pm, staff interviews were initiated. Interviews revealed that Resident #1 (R1) had a sudden and steep decline in their health. According to staff, R1 appeared weak, had increase impulsiveness, inaudible speech, decrease attention to safety, a fall risk, an over active bladder, and an inability to self-feed. R1's family was immediately made of aware of R1's change in medical condition. Between 1:00pm and 2:00pm. LPA reviewed facility records. Records revealed that on 9/05/2023, R1 was reappraised. On 9/04/2023 R1's needs and services plan was updated and on 9/07/2023 R1's physician report was updated as well. Per physicain report it was recommended by the doctor that R1 be sent to a skilled nursing facility due to requiring a higher level of care as their condition had worsened.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Rosaura Valenzuela	TELEPHONE: 818-596-4334
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

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 31-AS-20230907153007

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
WOODLAND HILLS S.RO, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364

FACILITY NAME: BROADVIEW RESIDENTIAL CARE CENTER	FACILITY NUMBER: 191221839
	VISIT DATE: 09/14/2023

NARRATIVE

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Based on interviews and records review, there is not sufficient information to support this allegation. Therefore, this allegation is deemed UNSUBSTANTIATED at this time.

It was alleged that facility staff restrained a resident in care by placing chairs around their bed. To investigate this allegation on 9/14/2023 between 12:00pm and 12:30pm, staff interviews were initiated. Interviews revealed that Resident #1 (R1) was a fall risk due to a worsening of their medical condition. In order to make sure that R1 did not fall, staff were asked to check on them every fifteen minutes. In addition, one chair was placed next to the bed so that R1 could be transferred in and out of their bed. The chair was not used to restrain R1.

Based on interviews there is not sufficient information to support this allegation. Thus, this allegation is UNSUBSTANTIATED at this time.

It was reported that staff handle residents in a rough manner. To investigate this allegation on 9/14/2023 between 12:00pm and 12:30pm, staff interviews were initiated. Interviews revealed that staff are cordial and helpful towards residents. Residents personal rights are respected. Between 3:00pm and 3:35pm, resident interviews were initiated. Interviews revealed that staff are kind and assist when called upon.

Based on observation and interviews, there is not sufficient information to support this allegation. Therefore, this allegation is UNSUBSTANTIATED at this time.

It was alleged that facility staff do not dispense medications according to physician's orders. Between 2:45pm and 3:00pm, R1's medical administration record (MAR) was reviewed. LPA did not note any discrepancies. Medications that were administered were initialed by the facility medical technicians. R1's MAR showed that medications were being dispensed daily. Between 3:00pm and 3:30pm, staff were interviewed. Interviews revealed that medications are being dispensed in a timely manner daily and on schedule. Between 3:00pm and 3:35pm, resident interviews were initiated. Interviews revealed that they are given their medication on time and do not report any issues.

Based on records review and interviews, there is not sufficient information to support this allegation. Thus, it is deemed UNSUBSTANTIATED at this time.

Exit interview conducted and a copy of the report was issued.

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: Rosaura Valenzuela	TELEPHONE: 818-596-4334
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

LIC9099 (FAS) - (06/04)

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