197603664-4-18-2023-11-AS-MVAO-CRWULW-20230517154124

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197603664
Report Date: 04/18/2023
Date Signed: 04/18/2023 03:56:25 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/10/2023 and conducted by Evaluator Lourdes Montoya

COMPLAINT CONTROL NUMBER: 11-AS-20230410151824

FACILITY NAME:	PATRICIA'S ELDER CARE		FACILITY NUMBER:	197603664
ADMINISTRATOR:	BRITO, PATRICIA		FACILITY TYPE:	740
ADDRESS:	2446 W. 234TH ST.		TELEPHONE:	(310) 530-8946
CITY:	TORRANCE	STATE: CA	ZIP CODE:	90501
CAPACITY:	6	CENSUS: 6	DATE:	04/18/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	DAVID GENER		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Staff do not assist resident with incontinence needs.

INVESTIGATION FINDINGS:

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On 04/18/2023, Licensing Program Analyst (LPA) Lourdes Montoya conducted an unannounced 10-day complaint visit at this facility. LPA was greeted by Administrator David Gener. LPA explained the purpose of the visit. LPA observed two staff and six residents present during the visit.

The investigation consists of the following: LPA Montoya interviewed two staff (S1-S2) and five residents (R1-R5). LPA was unable to interview one resident (R6) because he had difficulty staying awake due to medications. LPA interviewed one staff (S3) by telephone. LPA reviewed R1’s service records. A tour of the facility was conducted.

Report continued in LIC 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Lourdes Montoya	TELEPHONE: (510) 725-7918
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20230410151824

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: PATRICIA'S ELDER CARE	FACILITY NUMBER: 197603664
	VISIT DATE: 04/18/2023

NARRATIVE

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INVESTIGATION REVEALED THE FOLLOWING:

Regarding allegation: Staff do not assist resident with incontinence needs.

Based on LPA’s records review, R1 was admitted to the facility on 2/1/2023. R1 is non-ambulatory, uses a wheelchair and not able to care own toileting needs.

Based on LPA’s interview, five out of six residents have incontinence needs. During interview, R1 stated S3 told R1 that the schedule to clean and change resident’s diaper is three times a day, every after meal. R1 stated since R1 moved into the facility, S3 had always refused to assist with incontinence needs outside the aforementioned schedule. R1 stated, on 4/7/2023 S1 refused to provide assistance with incontinence needs. S1 and S2 stated that R1 always wants immediate incontinence assistance. S1 and S2 stated when they are busy with other residents, they inform R1 to wait for 10-15 minutes but R1 yells and insists that staff assist R1 right away. Interview revealed S3 assists R1 every time R1 asks for help with incontinence needs. Based on LPA’s Interview, three staff (S1-S3) and three residents (R3-R5) denied the allegation that staff do not assist resident with incontinence needs. R2 stated “I don’t know”. “I don’t have incontinence needs”. R4 revealed staff provide timely incontinence assistance whenever R4 needs help. Based on information gathered, there is no sufficient evidence to corroborate the above allegation.

Based on LPA’s observation, interviews conducted, and records reviewed, the preponderance of evidence standard has not been met. 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 above allegation is Unsubstantiated.

An exit interview was conducted with Administrator David Gener and a copy of the report was provided.

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Lourdes Montoya	TELEPHONE: (510) 725-7918
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

LIC9099 (FAS) - (06/04)

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