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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197603385
Report Date: 07/27/2023
Date Signed: 07/27/2023 12:09:54 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
05/24/2023 and conducted by Evaluator Alma Gonzalez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20230524120512
FACILITY NAME:COMMONWEALTH ROYALE GUEST HOMEFACILITY NUMBER:
197603385
ADMINISTRATOR:KITT, GARYFACILITY TYPE:
740
ADDRESS:150 S. COMMONWEALTH AVETELEPHONE:
(213) 382-6381
CITY:LOS ANGELESSTATE: CAZIP CODE:
90004
CAPACITY:99CENSUS: 93DATE:
07/27/2023
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Gary KittTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff leave facility doors open and cigarette smoke seeps into the facility
Staff do not serve nutritious foods to residents
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Alma Gonzalez conducted a subsequent complaint visit to deliver investigation findings for the above stated allegations. LPA met with Administrator Gary Kitt and explained the reason for the visit.

The investigation consisted of: During the initial visit conducted on 05/30/23, LPA conducted interviews with Administrator Anna Rempel. LPA collected copies of Staff and Resident Rosters. LPA also conducted a tour of the facility inside and out including included lobby, dining room, outside patio areas, kitchen and two designated smoking areas. On 07/27/23, LPA collected copies of Staff and Resident Roster and interviewed Staff 1-3 (S1-3) and Residents 1-9 (R1-9). LPA additionally requested a copy of facility menu and conducted a tour of facility including kitchen, food storage, and outside designated smoking area.


(See LIC9099C for continuation)
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Wei Siew HoTELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Alma GonzalezTELEPHONE: (323) 981-3973
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
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 3
Control Number 28-AS-20230524120512
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: COMMONWEALTH ROYALE GUEST HOME
FACILITY NUMBER: 197603385
VISIT DATE: 07/27/2023
NARRATIVE
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Investigation revealed the following: Regarding allegation, Staff leave facility doors open and cigarette smoke seeps into the facility, it is alleged that due to residents smoking outside and the doors being left open, the smoke comes into the facility causing facility resident discomfort and giving resident the need to wear a mask. Interviews with Administrator Kitt, Assistant Administrator Rempel, and S1-3 revealed that smoking is not allowed inside the facility including resident rooms. They stated that residents have a designated smoking area outside of the building. Staff stated that residents who smoke do so in the designated smoking area that is located outside of the facility and some residents take walks when they smoke. Staff stated that there are ash trays, a seating area and trash cans available for residents use. Staff stated that they have not received any concerns from any resident stating that smoke comes into the facility or their rooms causing them discomfort. They stated that there are some residents that still choose to use a mask. Staff additionally stated that when residents that smoke come into the building after smoking either outside or in the designated smoking area, they do smell of smoke. Interviews conducted with 7 out of 9 residents revealed that residents do not smoke inside the facility or their rooms and only smoke in the outside designated smoking area. They also stated that they do not have concerns regarding the smell of smoke inside the facility or their rooms. They stated that they are comfortable living in the facility and do not have any concerns. LPA observed outside designated smoking area and observed residents smoking only in that area. LPA observed trash cans, benches/ chairs and ash trays available for residents use. LPA did not observe any resident smoking in their rooms and did not smell any trace of tobacco in resident rooms or the facility during the tour. Based on interviews conducted with facility staff, facility residents, and LPA observations there was not enough supportive evidence to concur with the reported allegation.

For allegation, Staff do not serve nutritious foods to residents, it is alleged that the food that is served at the facility is not nutritious, and that the facility allegedly serves canned foods to residents which is not healthy, and residents should be getting fresh veggies and fresh fruits. Interviews conducted with 7 out of 9 residents revealed that they are satisfied with the food service provided at the facility. They stated that the food is healthy and satisfying, they have different food options and if they do not want what is on the menu, they can request a different meal option. They stated that the facility always has water available for residents to drink and have juices and coffee and soda upon request. They stated that they are served fresh fruit and vegetables daily and they denied that they are only served canned fruits and vegetables. Administrator Kitt, Assistant Administrator Rempel, and S1-3 stated that the facility ensures that the meals that are served to the residents are nutritionally balanced and that the residents always have fresh drinking water, juices, and
SUPERVISOR'S NAME: Wei Siew HoTELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Alma GonzalezTELEPHONE: (323) 981-3973
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20230524120512
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: COMMONWEALTH ROYALE GUEST HOME
FACILITY NUMBER: 197603385
VISIT DATE: 07/27/2023
NARRATIVE
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coffee. Staff stated that the facility ensures that the meals that are served to residents are nutritious, and that the facility always ensures to serve fresh fruits and vegetables with their meals. They stated that they also ensure to have fruits such as apples, oranges, and bananas for residents to have as additional healthier snacks. LPA toured the facility kitchen and observed staff in the process of preparing lunch for the residents. LPA observed the lunch meal to be well balanced with a selection of fresh fruits and vegetables. Based on LPA observations, LPA review of facility menu, and statements gathered from interviews conducted with staff and residents there was not enough supportive evidence to concur with the reported allegation.

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, therefore the allegations are UNSUBSTANTIATED.

Exit interview held. A copy of the report was provided to Administrator Gary Kitt.
SUPERVISOR'S NAME: Wei Siew HoTELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Alma GonzalezTELEPHONE: (323) 981-3973
LICENSING EVALUATOR SIGNATURE:

DATE: 07/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3