197603952-5-25-2021-28-AS-MVAO-C5RQGC-20210810120918

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197603952
Report Date: 05/25/2021
Date Signed: 05/25/2021 10:47:38 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
02/08/2021 and conducted by Evaluator Mary G Flores

COMPLAINT CONTROL NUMBER: 28-AS-20210208112024

FACILITY NAME:	PROSPECT MANOR		FACILITY NUMBER:	197603952
ADMINISTRATOR:	LYDIA PABION		FACILITY TYPE:	740
ADDRESS:	800 PROSPECT AVE		TELEPHONE:	(626) 799-1141
CITY:	SOUTH PASADENA	STATE: CA	ZIP CODE:	91030
CAPACITY:	99	CENSUS:	DATE:	05/25/2021
		UNANNOUNCED	TIME BEGAN:	08:51 AM
MET WITH:	Lydia Pabion - Administrator		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Facility is not kept at a comfortable temperature for residents in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mary Flores conducted a complaint investigation regarding the above allegation. LPA met with Lydia Pabion administrator and explained the reason for the visit.

The investigation consisted of the following: 2/16/21 LPA Flores conducted telephone interviews with the administrator and licensee, and a video call which consisted of a review of physical plant. The LPA also requested copies of staff roster and resident roster to be emailed. On 5/25/21 LPA conducted interviews with residents #1(R1),#2R2),#3(R3),#4R4),#5(R5), #6(R6) and staff #2(S2),#3(S3),#4(S4),#5(S5). LPA observed facility's thermostats in first floor located next to room #120 and second floor next to room #231.

The investigation revealed the following: Regarding allegation; Facility is not kept at a comfortable temperature for residents in care. It is alleged the facility is cold and the administrator, Lydia ignores it. During the virtual tour on 2/16/21 LPA observed the following thermostat #1(T1) which showed temperature at 76 degrees and is located in the dinning room. Thermostat #2(T2) at 77 degrees located in the hallway adjacent to room 107. Thermostat #3(T3) at 76 degrees in hallway adjacent to room 111. (CONTINUED LIC 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rebecca Orendain	TELEPHONE: (323) 981-3961
LICENSING EVALUATOR NAME: Mary G Flores	TELEPHONE: (323) 981-3965
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021

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 28-AS-20210208112024

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: PROSPECT MANOR	FACILITY NUMBER: 197603952
	VISIT DATE: 05/25/2021

NARRATIVE

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Thermostat #4(T4) at 76 degrees in hallway adjacent to room #119. Thermostat #5 (T5) at 75 degrees in hallway adjacent to room 232 and thermostat #6 (T6) at 74 degrees in hallway adjacent to room #226. Licensee explained that facility thermostats are connected to an application that allows licensee, administrator, and maintenance person to control the temperature from their cellphone and facility has a key accessible to adjust the thermostats if necessary. During the visit on 5/25/21 LPA Flores observe thermostat in second floor next to room #231 reading 77 degrees and set up at 77 degrees, and thermostat in first floor next to room #120 reading at 75 degrees. During interviews 4 out of 6 residents interview stated facility keeps a comfortable temperature and if they notify staff temperature gets adjusted right away. 2 out of 6 residents stated that it could get too cold or too hot but they notify staff and they adjust temperature according, an/or use heater or fan in their room. 5 out 5 staff interview stated facility is kept at a comfortable temperature, residents haven't reported temperature to be uncomfortable, and 3 out of 5 staff stated to have the application on their cellphone to adjust temperature if necessary.

Based on observation and interviews conducted the preponderance of evidence standard has been met, therefore the above allegation(s) are found UNSUBSTANTIATED.

Exit interview was conducted with Lydia Pabion administrator and a copy of this report was provided.

SUPERVISOR'S NAME: Rebecca Orendain	TELEPHONE: (323) 981-3961
LICENSING EVALUATOR NAME: Mary G Flores	TELEPHONE: (323) 981-3965
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021

LIC9099 (FAS) - (06/04)

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