191290642-2-27-2023-28-AS-TVAO-CQ5Q2H-20230321114711

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191290642
Report Date: 02/27/2023
Date Signed: 02/27/2023 02:57:33 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/09/2022 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20221209095910

FACILITY NAME:	LEISURE VALE RETIREMENT HOTEL		FACILITY NUMBER:	191290642
ADMINISTRATOR:	JESSE MOTA		FACILITY TYPE:	740
ADDRESS:	413 E. CYPRESS		TELEPHONE:	(818) 244-2323
CITY:	GLENDALE	STATE: CA	ZIP CODE:	91205
CAPACITY:	199	CENSUS: 93	DATE:	02/27/2023
		UNANNOUNCED	TIME BEGAN:	12:25 PM
MET WITH:	Celia Garcia, Administrator		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff are not preventing residents from smoking cigarettes/marijuana inside the facility.
Staff are not trained for emergency disasters.
Staff are retaliating against resident for complaints filed.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent visit regarding the allegations listed above. LPA met with Administrator, Celia Garcia, and explained the purpose of the visit.

On 12/13/22, LPA Chan conducted the initial complaint visit. LPA Chan toured the facility and obtained copies of the documents: Staff roster, Resident roster, House Rules, and Fire Drill/Disaster reports for year 2022. Interviews were held with the Administrator, 5 Staff, and 9 Residents. LPA requested for the registry agencies contact information. During the visit today, LPA interviewed another staff and a supervisor from the Alpha Care Staffing agency.

The investigation revealed the following: In regards to allegation – Staff are not preventing residents from smoking cigarettes/marijuana inside the facility. During the tour on 12/13/22, LPA did not observe any residents smoking or smell any cigarette/marijuana inside the facility. The smoking area is located outdoors towards the back of the main building and has a sign posted.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Tony Vasallo	TELEPHONE: (323) 981-3977
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023

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 28-AS-20221209095910

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: LEISURE VALE RETIREMENT HOTEL	FACILITY NUMBER: 191290642
	VISIT DATE: 02/27/2023

NARRATIVE

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Residents were observed smoking in that area only. Per Administrator and staff, residents who smoke do so outside only. They are not aware of any residents smoking marijuana. They have not seen any residents smoking inside the facility, otherwise they will remind them smoking is not allowed indoors and should go to the designated outdoor area. Nine (9) Residents were interviewed, some smokers and some not. 8 out of the 9 stated that the residents do not smoke inside the facility but outside in the designated smoking area.

In regards to allegation – Staff are not trained for emergency disasters. It is alleged there are not enough trained staff for emergency disasters since the facility utilizes registry staff often. Administrator indicated they have a contract with the Alpha Care agency to obtain additional staffing if necessary. They are actively searching to hire more full-time staff and do not rely on agency staff to fulfill staffing on a regular basis. Administrative staff stated that when they do use registry staff, they try to request for the same caregivers who are familiar with the grounds and residents. When they have any fire or disaster drills, the agency staff also participates if they are working during the drill. In addition, staff stated there is always one to two full-time staff who will work with the agency staff in the overnight shift. In the event of any emergency, staff know where to obtain the emergency contact numbers/LIC610 Emergency Disaster Plan. LPA observed the emergency disaster plan posted and a Fire and Disaster Guidelines binder by the front desk. LPA also interviewed the Alpha Care Staffing Agency supervisor who indicated that their qualified staff are provided with training on how to handle emergency situations. Also, agency staff should be given an orientation when they arrive to the facility. 7 out of the 9 residents interviewed feel that the staffing is sufficient and staff are well trained for emergencies.

In regards to allegation – Staff are retaliating against residents for complaints filed. Administrator and Staff denied retaliating against any residents who file complaints. They stated that they do not know who file complaints and the Complaint poster “LetUsNo” is posted on the wall in a prominent location. They assist and treat residents equally. The residents are entitled to file complaints whenever they wish and remain anonymous. LPA interviewed 9 residents and 8 of them do not feel that the staff would retaliate against anyone who files a complaint. The staff treat them fairly and respectfully.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

An exit interview was held with Administrator Garcia. A copy of this report along with the appeal rights were provided.

SUPERVISOR'S NAME: Tony Vasallo	TELEPHONE: (323) 981-3977
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 02/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/27/2023

LIC9099 (FAS) - (06/04)

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