197602345-8-29-2023-28-AS-RORN-CVML2E-20230913082211

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197602345
Report Date: 08/29/2023
Date Signed: 08/29/2023 03:50:05 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
08/25/2023 and conducted by Evaluator Mary G Flores

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230825103528

FACILITY NAME:	VILLA GARDENS		FACILITY NUMBER:	197602345
ADMINISTRATOR:	SHAUN RUSHFORTH		FACILITY TYPE:	741
ADDRESS:	842 EAST VILLA STREET		TELEPHONE:	(626) 796-8162
CITY:	PASADENA	STATE: CA	ZIP CODE:	91101
CAPACITY:	340	CENSUS: 237	DATE:	08/29/2023
		UNANNOUNCED	TIME BEGAN:	12:34 PM
MET WITH:	Shaun Rushforth - Administrator		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff spoke inappropriately to a resident in care.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

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

The investigation consisted of the following: LPA requested resident/staff roster. LPA interviewed staff #1-#6(S1-S6) and residents#1-10 (R1-R10). LPA requested a copy of administrator's personal rights training.

The investigation revealed the following: Regarding allegation: Staff spoke inappropriately to a resident in care. It is alleged administrator was going on a "rant" towards the resident, and then stormed out of the meeting. Interviews conducted with residents revealed, 9 out of 10 residents stated administrator is respectful, approachable, and helpful when speaking to residents. Administrator attempts to resolve any issues in a calm manner. 1 out of 10 residents interviewed stated that when presenting a concern to the administrator resident felt administrator walked away without providing a resolution.
(CONTINUED ON LIC 9099C)

Unsubstantiated

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: 08/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2023

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 28-AS-20230825103528

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: VILLA GARDENS	FACILITY NUMBER: 197602345
	VISIT DATE: 08/29/2023

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

Interview with administrator revealed, there was a conversation with a resident in which administrator did not feel the conversation was being productive. Administrator at the time let the resident know that based on how the conversation was going, it was best to stop the conversation and attempt to resolve it later. Administrator communicated to the resident he was walking away and will continue the conversation later. 5 out of 6 staff interviewed stated administrator is respectful when communicating with residents and attempts to resolve issues in a calmly manner. Per interviews conducted, administrator did walk away from the conversation. However, administrator was making a professional decision to avoid a conversation that had escalated and to resolve it in a calm and less hostile manner at a later time.

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.

Exit interview was conducted with Administrator Shaun Rushforth and a copy of this report was provided.

SUPERVISOR'S NAME: Tony Vasallo	TELEPHONE: (818) 419-8131
LICENSING EVALUATOR NAME: Mary G Flores	TELEPHONE: (323) 981-3965
LICENSING EVALUATOR SIGNATURE:	DATE: 08/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2