191500146-10-3-2023-28-AS-TVAO-CWGUXL-20231010155831

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191500146
Report Date: 10/03/2023
Date Signed: 10/03/2023 11:17:11 AM

Substantiated

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
12/07/2022 and conducted by Evaluator Mary G Flores

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20221207110657

FACILITY NAME:	ARTESIA CHRISTIAN HOME		FACILITY NUMBER:	191500146
ADMINISTRATOR:	MICHELLE ROBISON		FACILITY TYPE:	741
ADDRESS:	11614 EAST 183RD STREET		TELEPHONE:	(562) 865-5218
CITY:	ARTESIA	STATE: CA	ZIP CODE:	90701
CAPACITY:	143	CENSUS: 82	DATE:	10/03/2023
		UNANNOUNCED	TIME BEGAN:	09:23 AM
MET WITH:	Anne Walsh - Director of Residential Services		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Resident is being financially abused while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mary Flores conducted an unannounced subsequent complaint investigation visit regarding the above allegation. LPA met with Anne Walsh and explained the reason for the visit.

The investigation consisted of the following: On 12/13/22 LPA Flores conducted a complaint investigation visit and requested the following documents: copy of staff/resident roster, resident #1(R1)'s physician's report dated:4/8/22, admission agreement, face sheet, inventory list, out on pass sign out and incoming screening form for September, October, November 2022, visitor's log for September - November 2022, resident’s care matrix, resident appraisal, needs and care plan, pre-admission appraisal, service and flow sheet, resident care plan. LPA attempted to interview R1 and interviewed bank consultant over the phone. On 2/8/23, 2/27/23, 3/7/23 LPA received updates via incident reports to incident report submitted to the department on 12/13/22 and any pertinent documents regarding the investigation for staff #1 and #2(S1-S2).
(CONTINUED ON LIC 9099C)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Tony Vasallo	TELEPHONE: (818) 419-8131
LICENSING EVALUATOR NAME: Mary G Flores	TELEPHONE: (323) 981-3965
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

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-20221207110657

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: ARTESIA CHRISTIAN HOME	FACILITY NUMBER: 191500146
	VISIT DATE: 10/03/2023

NARRATIVE

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On 3/27/23, 8/10/23, 9/6/23 LPA contacted Detective Kyle Crowley from the Lakewood Sheriff Station Detective Bureau. On 9/20/23 LPA requested resignation letter for S2.

The investigation revealed the following: Regarding allegation: Resident is being financially abused while in care. It is alleged an elderly person's (who lives at the facility) checks were stolen and written out in the amount of $20,000. R1 was admitted to the assisted living section of the facility on 4/13/22. At the time of admission, R1 did not have any signs of dementia, confusion, or inappropriate behaviors per physician's report. Care plan dated 5/11/22 does not note changes in mental condition. On 11/22/22 R1 was transferred to the hospital due to pain and returned to the facility’s skill nursing on 11/25/22. The facility began to see a decline in cognitive condition after that. Interview conducted with administration staff on 12/13/22 determined the Lakewood Sheriff’s Detective Bureau had conducted a visit on 12/1/22 regarding the above allegation. During that visit the Detective attempted to interview R1 and was not able due to R1’s cognitive skills. During LPA’s initial visit on 12/13/22 an interview was attempted with R1, however due to R1’s cognitive skills LPA was not able to obtain a response. Interview with R1’s bank consultant over the phone revealed there had seem to be suspicious checks cashed recently from R1’s account. R1 had been a customer of the bank for quite some time and the activity was not usual for R1. At least 50 checks were cash between $500 - $2000 dollars for a total of at least $50,000.

On 1/25/23 facility received verbal communication from Detective Crowley that S1 had admitted to cashing checks for R1 and keeping a portion of the money. S1 was placed on administrative suspension effective 1/26/23 pending investigation. On 2/8/23 LPA obtained an updated via an incident report which provided Detective Crowley’s investigation update to the facility. Per the incident report Detective Crowley had informed facility’s administrator that S1 had been arrested for stealing over $50,000 dollars, writing over 80 checks since August 2022 from R1. The charges against S1 are money fraud, embezzlement, and grant theft. On the week of 2/20/23 Facility received a writing admission from Detective Crowley regarding the interview conducted with S1. S1 was terminated on 2/24/23 from employment at the facility. On 2/5/23 S2 gave the facility a resignation letter via email. On 3/7/23 LPA received an incident report with an update regarding a second staff (S2). The incident report stated that during an interview conducted by Detective Crowley on 3/1/23, S2 admitted to have stolen at least $1000 dollars in purchases and $1800 using “Venmo” to self. On 8/10/23 Detective Crowley informed LPA that the investigation conducted by the Lakewood Sheriff’s Detective Bureau was completed, and it was now under the DA’s office, on felony charges against S1. (CONTINUED ON LIC 9099C)

SUPERVISOR'S NAME: Tony Vasallo	TELEPHONE: (818) 419-8131
LICENSING EVALUATOR NAME: Mary G Flores	TELEPHONE: (323) 981-3965
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20221207110657

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: ARTESIA CHRISTIAN HOME	FACILITY NUMBER: 191500146
	VISIT DATE: 10/03/2023

NARRATIVE

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On 9/20/23 Detective Crowley confirmed that S2 had admitted to stealing from R1. LPA interviewed S2 over the phone, who stated to have made purchases for self with R1’s card with R1’s permission. Due to the cognitive state of R1 we were not able to determine whether R1 consent to the purchases. However, S2 did not follow Facility’s "Policy and Procedure K-400 entitled Gratuities and K-410 Guidelines" for accepting and rejecting gratuities.

Based on LPAs document review and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099D.

Exit interview was conducted with Anne Walsh and a copy of this report, LIC 9099D, and appeal rights were provided.

SUPERVISOR'S NAME: Tony Vasallo	TELEPHONE: (818) 419-8131
LICENSING EVALUATOR NAME: Mary G Flores	TELEPHONE: (323) 981-3965
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 28-AS-20221207110657

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: ARTESIA CHRISTIAN HOME	FACILITY NUMBER: 191500146
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/03/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 10/04/2023 Section Cited CCR 87462.8(a)(8)	1 2 3 4 5 6 7	87468.2 Additional Personal Rights of Residents in Privately Operated Facilities: (a)In addition... residents... shall have all of the following personal rights: (8) To be free..., financial exploitation,.. This requirement is not met as evidence by:	1 2 3 4 5 6 7	Administrator will schedule training on Personal Rights to be given to all facility's staff and notify the department of date training will be provided by POC due date 10/4/23. Administrator will provide copies of training sign-in log with topic, and duration of training by 10/17/23.
	8 9 10 11 12 13 14	Based on interviews, and document review licensee did not ensure S1 and S2 did not financial abuse R1 while in care which poses an immediate risk to the health, safety, or personal rights of the persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Tony Vasallo	TELEPHONE: (818) 419-8131
LICENSING EVALUATOR NAME: Mary G Flores	TELEPHONE: (323) 981-3965
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2023

LIC9099 (FAS) - (06/04)

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