191500823-2-10-2022-11-AS-JHAD-CCANJM-20220307093031

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 191500823
Report Date: 02/10/2022
Date Signed: 02/10/2022 03:23:30 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/03/2022 and conducted by Evaluator Ulysses Coronel

COMPLAINT CONTROL NUMBER: 11-AS-20220203093827

FACILITY NAME:	HIGHLAND MANOR GUEST HOME		FACILITY NUMBER:	191500823
ADMINISTRATOR:	AARON KHODORKOVSKY		FACILITY TYPE:	735
ADDRESS:	3570 E. IMPERIAL HWY.		TELEPHONE:	(310) 631-7569
CITY:	LYNWOOD	STATE: CA	ZIP CODE:	90262
CAPACITY:	106	CENSUS: 93	DATE:	02/10/2022
		UNANNOUNCED	TIME BEGAN:	08:53 AM
MET WITH:	Aaron Khodorkovsky		TIME COMPLETED:	03:39 PM

ALLEGATION(S):

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Staff hits clients in care
Staff yells at clients in care.
Staff did not safeguard client's personal property
Staff is stealing client's cash resources
Staff are not providing adequate food service to client in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ulysses Coronel initiated a complaint investigation for the allegation listed above. LPA met with Aaron Khodorkovsky, administrator and the purpose of the visit was explained.

The investigation consisted of the following: During today’s visit LPA and staff Itzia Maciel conducted a tour of the facility. LPA interviewed administrator, 5 staff and 10 out of 93 clients. LPA also reviewed and obtained clients’ and facility records such as admission agreements, records of clients safeguarded cash resources and bank statements.

The investigation revealed the following: Regarding the allegation “Staff hits clients in care”, it is alleged that staff hit clients with closed fist and staff is hitting clients’ hands. During today’s interviews the administrator and 5 out of 5 staff interviewed denied hitting clients, denied witnessing staff hitting clients and denied receiving complaints that staff are hitting clients, staff S5 stated “I only hold out my hand to control the distance between me and the client.”

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ulysses Coronel
LICENSING EVALUATOR SIGNATURE:	DATE: 02/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 3

Control Number 11-AS-20220203093827

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: HIGHLAND MANOR GUEST HOME	FACILITY NUMBER: 191500823
	VISIT DATE: 02/10/2022

NARRATIVE

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10 out of 10 clients interviewed denied being hit by staff, denied witnessing staff hitting clients and denied hearing other clients complaint that staff are hitting clients, client C3 stated “I have been here 8 months now and I know what’s going and no staff is hitting clients here.” Regarding the allegation “Staff hits clients in care.” Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Regarding the allegation: “Staff yells at clients in care.” During today’s interviews, the administrator and 5 out of 5 staff interviewed denied yelling at clients, denied witnessing staff yelling at clients and denied receiving complaints about staff yelling at clients, staff S1 stated “Sometimes I need to talk louder if I’m talking to a client who is hard of hearing or when both of us are wearing masks.” 10 out of 10 clients interviewed denied being yelled at by staff, denied witnessing staff yelling at other clients and denied hearing other clients complaint that they were being yelled at by staff. Client C3 stated “No, the staff are nice, sometimes they have to talk louder to get understood when there is loud music being played or they need to give instructions to the people here. Regarding the allegation “Staff yells at clients in care.”: Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Regarding the allegation: “Staff did not safeguard client's personal property.”, it is alleged that staff are stealing properties from client’s rooms. During today’s interviews, the administrator and 5 out of 5 staff interviewed denied receiving complaints about staff stealing clients personal property, staff S2 stated “Recently, one of the clients complained that someone stole their clothes and I notified the Aaron, the same day we found them in the laundry room.” 9 out of 10 clients interviewed denied being stolen from, denied witnessing other clients being stolen from and denied hearing other clients complain that they were being stolen from by staff. Client C3 stated “Sometimes when clients want something, they claim that someone stole it from them.” Client C8 stated that “Someone took my driver’s license, credit card and scooter, I don’t remember where or when it happened.” Regarding the allegation “Staff did not safeguard client's personal property” Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ulysses Coronel
LICENSING EVALUATOR SIGNATURE:	DATE: 02/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20220203093827

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: HIGHLAND MANOR GUEST HOME	FACILITY NUMBER: 191500823
	VISIT DATE: 02/10/2022

NARRATIVE

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Regarding the allegation: “Staff is stealing client's cash resources.”, it is alleged that staff taking money from clients checks. During today’s visit LPA reviewed clients records of clients safeguarded cash resources and observed that each cash withdrawn from client’s cash resources is signed by a staff and by the clients drawing from their account. During today’s interviews, the administrator and 5 out of 5 staff interviewed denied receiving complaints about staff taking money from clients checks, The administrator stated that “The clients P&I are divided into weekly “draws”, although we do give them the whole amount or whatever is available in their account upon demand.”, staff S2 stated “I help the administrator with money draws on Mondays, some clients demand their whole check earlier in the month, then they end up complaining when they have used up their money.” 10 out of 10 clients interviewed did not have any complaints about their cash resources being stolen by staff and denied hearing other clients complain about their cash resources being stolen by staff. Regarding the allegation “Staff is stealing client's cash resources.” Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

Regarding the allegation: “Staff are not providing adequate food service to client in care”, it is alleged that clients are not being served alternative foods and are being served the same food for all meals during the day. During today’s visit LPA conducted a tour of the kitchen and observed supplies of staple nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days, LPA also observed a 4 week menu plan posted in the hallway and in the kitchen, LPA observed a variety of dishes listed for each meal on the menu posted. During today’s interviews, the facility cook S4 stated that “I am following the menu provided posted in the kitchen, I try to give them different food when they request for it, recently Aaron told me that one of the clients sugar was high, I prepared them chicken and vegetables instead.” 8 out of 10 clients interviewed did not have any complaints about being provided with alternative meals or with the variety of food being served, C10 stated I am a diabetic and they do give me a different food when I ask for it.” 1 out of 10 client C9 stated “The food can get repetitious sometimes, but I’m not complaining.” Regarding the allegation “Staff are not providing adequate food service to client in care.” Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.

No deficiencies were cited. An exit interview was conducted, and a copy of this report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ulysses Coronel
LICENSING EVALUATOR SIGNATURE:	DATE: 02/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022

LIC9099 (FAS) - (06/04)

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