197605175-1-9-2023-31-AS-NMAN-CR3UX6-20230420155747

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197605175
Report Date: 01/09/2023
Date Signed: 01/09/2023 12:50:34 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
01/03/2023 and conducted by Evaluator Abeye Duguma

COMPLAINT CONTROL NUMBER: 31-AS-20230103114611

FACILITY NAME:	GOCHIN CARE FACILITY		FACILITY NUMBER:	197605175
ADMINISTRATOR:	RHODA GOCHIN		FACILITY TYPE:	735
ADDRESS:	8112 LOMA VERDE AVENUE		TELEPHONE:	(818) 349-1767
CITY:	CANOGA PARK	STATE: CA	ZIP CODE:	91304
CAPACITY:	4	CENSUS: 4	DATE:	01/09/2023
		UNANNOUNCED	TIME BEGAN:	09:02 AM
MET WITH:	Rhoda Gochin		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Staff leave resident soiled for extended periods of time.
Staff are not meeting resident's hygiene needs.
Staff are not providing resident clean clothing.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Abeye Duguma conducted an unannounced initial complaint visit to this facility to investigate the above allegations. LPA met with the administrator, Rhoda Gochin, and explained the reason for the visit.

--- Staff leave resident soiled for extended periods of time.

LPA made observations during a physical plant tour at around 09:15 AM, interviewed one (01) staff and one (01) resident between 10:30 AM to 11:30 AM and at 12:00 PM, LPA interviewed the Reporting Party (RP). LPA observed depends diapers in Resident #1’s (R1) closet. R1 was clean and well groomed. LPA did not experience any malodor. During interviews with R1, they stated that they are able to handle incontinent care, such as wiping and changing diapers, independently. When LPA asked R1 if they are left soiled for an extended period, R1 replied, “No. I change myself”.
(Cont. LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2023

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 31-AS-20230103114611

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: GOCHIN CARE FACILITY	FACILITY NUMBER: 197605175
	VISIT DATE: 01/09/2023

NARRATIVE

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During interviews with Staff #1 (S1), they stated that the resident is mostly independent, but that they assist as needed to meet R1's needs. S1 stated that R1 often feels embarrassed around peers when being assisted and will avoid seeking assistance or withhold information. S1 stated that R1 is able to change their own diaper independently but that staff are on standby for assistance. During interviews with the RP, they stated that R1’s diaper is not changed often enough and R1 is malodorous. Based on observations and interviews, there is not enough information to verify the allegation, therefore, the allegation is unsubstantiated at this time.

---Staff are not meeting resident's hygiene needs.

LPA made observations during a physical plant tour at around 09:15 AM and interviewed one (01) staff and one (01) residents between 10:30 AM to 11:30 AM. LPA observed that R1 was clean and well groomed. LPA did not experience any malodor. During interviews with R1, they stated that they are able to shower independently but that the staff are available if they need the assistance. During interviews with Staff #1 (S1), they stated that the resident is mostly independent, but that they assist as needed to meet R1's needs. S1 also stated that R1 showers up to three (03) times a week and sometimes refuses. S1 stated that R1 often feels embarrassed around peers when being assisted and will avoid seeking assistance. S1 stated that R1 often sits during showering and S1 is on standby to remind R1 to clean certain areas and often assists with hard to reach areas. During interviews with the RP, they stated that R1 exhibits signs of neglect, bad hygiene, had dry blood from a wound and that R1 is malodorous from not showering. Based on observations and interviews, there is not enough information to verify the allegation, therefore, the allegation is unsubstantiated at this time.

---Staff are not providing resident clean clothing.

LPA made observations during a physical plant tour at around 09:15 AM and interviewed one (01) staff and one (01) residents between 10:30 AM to 11:30 AM. LPA observed that R1 was clean and well groomed. LPA did not experience any malodor. During interviews with R1, they stated that they are able to change their cloths independently, the facility staff does their laundry frequently and arranges clean clothes for changing. During interviews with Staff #1 (S1), they stated that the resident is mostly independent, but that they assist as needed to meet R1's needs.
(Cont. on LIC9099-C)

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2023

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20230103114611

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: GOCHIN CARE FACILITY	FACILITY NUMBER: 197605175
	VISIT DATE: 01/09/2023

NARRATIVE

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S1 also stated that R1 often refuses to change cloths and has a tendency to be fixated on the things that they like. S1 further explained that they purchased R1 cloths from their own pocket and R1 likes to wear the same pants day and night. S1 stated that R1 often feels embarrassed around peers when being assisted and will avoid seeking assistance or withhold information. S1 stated that the facility does laundry once a week or more if needed. During interviews with the RP, they stated that R1 wears the same cloths repeatedly and that the cloths are not clean. Based on observations and interviews, there is not enough information to verify the allegation, therefore, the allegation is unsubstantiated at this time.

No health and safety hazards noted during the visit.

Exit interview conducted. Copy of this report issued.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: Abeye Duguma
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2023

LIC9099 (FAS) - (06/04)

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