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Department of
SOCIAL SERVICES
Community Care Licensing
COMPLAINT INVESTIGATION REPORT
Facility Number:
197602540
Report Date:
04/13/2022
Date Signed:
04/13/2022 04:52:45 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
11/15/2019
and conducted by Evaluator
Wendell Smith
COMPLAINT CONTROL NUMBER:
31-AS-20191115154931
FACILITY NAME:
PRESTIGE ASSISTED LIVING AT LANCASTER
FACILITY NUMBER:
197602540
ADMINISTRATOR:
MARIA MULLINS
FACILITY TYPE:
740
ADDRESS:
43454 30TH STREET WEST
TELEPHONE:
(661) 949-2177
CITY:
LANCASTER
STATE:
CA
ZIP CODE:
93536
CAPACITY:
68
CENSUS:
41
DATE:
04/13/2022
UNANNOUNCED
TIME BEGAN:
10:30 AM
MET WITH:
Karen Marin
TIME COMPLETED:
02:20 PM
ALLEGATION(S):
1
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9
Facility has Insufficient staff to meet the residents' needs.
Facility staff failed to respond to residents' emergency call button in a timely manner
Staff have not received adequate training.
Facility staff mismanages resident's medication
INVESTIGATION FINDINGS:
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13
Licensing Program Analyst (LPA) Wendell Smith conducted an unannounced subsequent complaint visit to investigate the allegations above. LPA met with the administrator and explained the reason for this visit.
LPA conducted a physical plant tour to ensure no immediate health and safety issues. No health and safety issues were noted.
Facility has insufficeint staff to meet resident's needs
It is alleged that there is not enough staff to meet resident needs in the facility. LPA conducted interviews with residents and staff from approximately 11:15-1:30pm regarding this allegation. All residents and staff interviewed feel that the facility has enough staff and resident's needs are getting met by facility staff. Based on the information obtained through interviews this allegation is deemed Unsubstantiated at this time.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME:
Cassandra Harris
TELEPHONE:
(818) 596-4342
LICENSING EVALUATOR NAME:
Wendell Smith
TELEPHONE:
(818) 738-4525
LICENSING EVALUATOR SIGNATURE:
DATE:
04/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
04/13/2022
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
31-AS-20191115154931
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:
PRESTIGE ASSISTED LIVING AT LANCASTER
FACILITY NUMBER:
197602540
VISIT DATE:
04/13/2022
NARRATIVE
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Facility staff failed to respond to residents' emergency call button in a timely manner
It is alleged that facility staff to not respond in a timely manner to resident's call button. LPA interviewed residents and staff from approximately 11:15-1:30pm regarding this allegation. Information obtained from resident and staff interviews reveal that facility staff respond in an adequate amount of time once the call button is pushed. Based on the information obtained through interviews this allegation is deemed Unsubstantiated at this time.
Staff have not received adequate training.
It is alleged that staff do not receive adequate training. LPA conducted interviews with facility staff regarding this allegation. LPA also reviewed four random staff records from 10:45am-11:15am. A review of staff records show that facility staff have received appropriate training upon being hired and receive monthly training. Based on the information obtained through interviews and record review this allegation is deemed Unsubstantiated at this time.
Facility staff mismanages resident's medication
It is alleged that facility staff have lost resident's medications and mismanaged medications. LPA conducted interviews with residents and staff from 11:15-1:30pm. LPA interviewed staff who are responsible for handling medications for residents. All residents interviewed stated there was no issue with medications and the way they are being assisted with their medications. No one stated they missed medications or were given the wrong medications. Based on the information obtained this allegation is deemed Unsubstantiated at this time.
Exit Interview conducted.
SUPERVISOR'S NAME:
Cassandra Harris
TELEPHONE:
(818) 596-4342
LICENSING EVALUATOR NAME:
Wendell Smith
TELEPHONE:
(818) 738-4525
LICENSING EVALUATOR SIGNATURE:
DATE:
04/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
04/13/2022
LIC9099
(FAS) - (06/04)
Page:
2
of
3