<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 191600315
Report Date: 11/30/2022
Date Signed: 11/30/2022 01:06:04 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, 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
04/05/2021 and conducted by Evaluator Michael Cava
COMPLAINT CONTROL NUMBER: 31-AS-20210405135939
FACILITY NAME:ESPERANCE CENTERFACILITY NUMBER:
191600315
ADMINISTRATOR:OBRADOVIC, STEVAN JAMESFACILITY TYPE:
735
ADDRESS:30711 MONTE LADO DRIVETELEPHONE:
(310) 457-1840
CITY:MALIBUSTATE: CAZIP CODE:
90265
CAPACITY:6CENSUS: DATE:
11/30/2022
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:James ObradovicTIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff leaves resident unattended in soaking wet clothing for extended periods of time
Staff failed to keep the facility clean
Staff failed to meet the resident's needs
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Michael Cava conducted a subsequent complaint visit to the facility to conclude the investigation regarding the aboe allegations. LPA met with the administrator, James Obradovic, and advised him of the visit. During the course of the day's visit, interviews and record review were made. A physical plant inspection was also conducted. At approximately 10:15am, LPA conducted a plant tour to insure the health and safety of the residents in care. At approximately 11:00am to 12:30pm, interviews and record review was made.

Staff leaves resident unattended in soaking wet clothing for an extended period of time:
In regards to the allegation, it was reported that Resident 1 (R1), who is incontinent, urinates everywhere, and staff1 (S1) leaves R1 unattended, soaking wet in their clothes. Interviews with the administrator do not corroborate with the allegation. According to the administrator, R1 did have a habit in wetting self, due to
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2022
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 2
Control Number 31-AS-20210405135939
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: ESPERANCE CENTER
FACILITY NUMBER: 191600315
VISIT DATE: 11/30/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
a bad bladder function. R1 does require the use of a diaper. As part of R1's care plan, R1 is monitored by staff when going to the bathroom, or wetting self. Staff would also encourage R1 to use the bathroom on own, and insure R1 is able to take care of their own hygiene needs such as wiping thoroughly and washing hands. When R1 does have an accident, staff insures to clean up the areas where R1 made his accidents. R1 no longer resided at the home. R1 moved out in July 2022. Review of R1's records does confirm that they require assistance with their bathroom and hygiene needs. Record review also indicates that goals in meeting these needs are partially met. The facility does have another resident that requires incontinent care, Resident 2 (R2). According to R2, they've never been left soaking wet in their clothing since moving in. R2 has lived in the home for over thirty years. Based on the information obtained, there was insufficient evidence to prove that R1 is being left soaking wet in their clothes for an extended period of time. Therefore, the allegation is deemed Unsubstantiated at this time.
Staff failed to keep the facility clean:
In regards to the allegation, it was reported that R1 would urinate on the floors and staff does not clean it up. It was also reported that R1's soiled clothing were mixed with the other residents clothing when R1's clothes are put in the wash. Interviews with the administrator reveal that when R1 soaks their clothing, R1's clothes are separated from the other resident clothes. Before putting it in the wash, R1's clothes are placed in a bucket to disinfect and sanitize. Clothing is also washed separately from the other resident linen to keep sanitary. In addition to interviews, LPA also conducted a physical plant inspection and didn't notice smell of urine or feces due to uncontrollable bladder or bowel movements. Facility was observed clean, safe and sanitary at the time of the LPA's investigation. Based on LPA's inspection of the physical plant, and information obtained during interviews, there was insufficient evidence to prove that facility isn't kept clean. Therefore, the allegation is deemed Unsubstantiated at this time.
Staff failed to meet the resident's needs:
In regards to the allegation, it was reported that R1 does not have any teeth, and staff deprives R1 of their pureed food. Interview with the administrator confirms that R1 does not have teeth and requires a special diet. Facility maintained powdered and pureed food for R1, which they still have some on stock in case R1 was to return. Interviews with R1's Social Worker reveal that they had no complaints with R1's diet and food intake. R1 had lived at the facility for over 30 years, and never experienced weight gain or weight loss during their residence at the home. Based on the information obtained, there was insufficient evidence to corroborate the allegation of staff failing to meet R1's dietary needs. Therefore, the allegation is deemed Unsubstantiated at this time.
SUPERVISORS NAME: Eva Miller
LICENSING EVALUATOR NAME: Michael Cava
LICENSING EVALUATOR SIGNATURE:

DATE: 11/30/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2