197602370-10-22-2024-11-AS-RORN-DBNTYC-20241205140830

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197602370
Report Date: 10/22/2024
Date Signed: 10/22/2024 04:44:35 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/16/2024 and conducted by Evaluator Alfonso Iniguez

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20241016015919

FACILITY NAME:	PINNACLES AT BURTON, THE		FACILITY NUMBER:	197602370
ADMINISTRATOR:	CHANEL ANN SANCHEZ		FACILITY TYPE:	740
ADDRESS:	8757 BURTON WAY		TELEPHONE:	(310) 278-8323
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90048
CAPACITY:	138	CENSUS: 24	DATE:	10/22/2024
		UNANNOUNCED	TIME BEGAN:	08:26 AM
MET WITH:	Channel Sanchez/Administrator		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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Staff are not feeding a resident in care.
Staff are neglecting the residents in care.

INVESTIGATION FINDINGS:

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On 10/22/2024 LPA Alfonso Iniguez conducted an unannounced complaint visit. LPA Iniguez met with Channel Sanchez /Administrator. LPA explained the purpose of this visit.

Investigation Consisted of: LPA conducted the following interviews: Administrator Interview(A#1), and Residents interviews (R#1-R#6). LPA obtained and reviewed the following documents: Client’s roster, Personnel roster, (R#1-R#4) Identification and Emergency Information, (R#1-R#4) Admissions agreements, (R#1-R#4) Physicians Report for Residential Care Facilities for the Elderly, (R#1-R#4) Needs and Services Plan, (R#1-R#4) Medication Administration Record (MAR) for the month of October 2024, copies of facility menu for 2 months.

Evaluation Report continues LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024

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 4

Control Number 11-AS-20241016015919

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: PINNACLES AT BURTON, THE	FACILITY NUMBER: 197602370
	VISIT DATE: 10/22/2024

NARRATIVE

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Investigation Revealed the Following:

Allegation: Staff are not feeding a resident in care.

The details of the complaint alleged that facility staff are not feeding the residents in care.

During the records review, LPA Iniguez reviewed copies of two months of the facility menu. LPA noted that the facility serves a variety of three meals per day: breakfast, lunch, and dinner. In addition, LPA observed that the meals meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council.

During an Interview with the Administrator (A#1), she stated that the facility offers three meals per day: breakfast, lunch, and dinner plus snacks. In addition, (A#1) stated that the meals provided by the facility are nutritious and well-balanced.

During interviews with residents (R#1-R#6), (6) out of (6) stated that the facility serves three meals per day plus snacks; also, they stated that the meals served by the facility are nutritious.

During interviews with staff (S#1-S#4), (4) out (4) stated that the facility serves three meals per day and snacks; also, they stated that the meals are nutritious.

Evaluation Report continues LIC 9099-C

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20241016015919

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: PINNACLES AT BURTON, THE	FACILITY NUMBER: 197602370
	VISIT DATE: 10/22/2024

NARRATIVE

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Allegation: Staff are neglecting the residents in care.

The details of the complaint alleged that facility staff are neglecting residents in care.

During the records review, LPA Iniguez reviewed the facility Personnel Report or LIC 500. LPA noted that there are two to three MedTech and a nurse available caregiver from Monday to Sunday for 24 residents in care total, and one caregiver available during the weekend.

During an interview with the administrator (A#1), she stated that three caregivers, MedTech and a nurse, are at the facility every day. She also stated that the facility staff is not neglecting the residents in care.

During interviews with residents (R#1-R#6), (6) out of (6) stated that there is enough staff to take care of them and the rest of the residents, and they also stated that the facility staff has never neglected them.

During interviews with staff (S#1-S#4), (4) out (4) stated that there are always three caregivers and a MedTech taking care of the residents. Also, they stated that they had never neglected a resident in care.

Evaluation Report continues LIC 9099-C

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 11-AS-20241016015919

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: PINNACLES AT BURTON, THE	FACILITY NUMBER: 197602370
	VISIT DATE: 10/22/2024

NARRATIVE

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During this investigation, LPA found did not find sufficient evident to support the above-mentioned allegations.

Based on the evidence gathered, interviews conducted, and records reviewed, the preponderance of evidence standard has been met; therefore, the above-mentioned allegation(s) are found to be UNSUBSTANTIATED.

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.

An exit interview was conducted, and a copy of the Complaint Report was given to Channel Sanchez /Administrator.

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Alfonso Iniguez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2024

LIC9099 (FAS) - (06/04)

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