197606145-9-7-2023-28-AS-FFIS-CVMUE7-20230913153038

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197606145
Report Date: 09/07/2023
Date Signed: 09/07/2023 05:31:23 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, 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
10/04/2021 and conducted by Evaluator Bonnie Tao

COMPLAINT CONTROL NUMBER: 28-AS-20211004122114

FACILITY NAME:	ARCADIA GARDENS RETIREMENT HOTEL		FACILITY NUMBER:	197606145
ADMINISTRATOR:	PAT REDNER		FACILITY TYPE:	740
ADDRESS:	720 W. CAMINO REAL		TELEPHONE:	(626) 574-8571
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91007
CAPACITY:	200	CENSUS: 164	DATE:	09/07/2023
		UNANNOUNCED	TIME BEGAN:	08:22 AM
MET WITH:	Pamela Parsons, Administrator		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff is not dispensing resident's medication as prescribed.
Staff are not serving a good quality of food.
Facility has ants.

INVESTIGATION FINDINGS:

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***This licensing report supersedes the original complaint investigation report, dated 06/23/22. The findings remain as Unsubstantiated. ***

Licensing Program Analyst (LPA) Tao conducted an unannounced subsequent complaint investigation for the allegations listed above on 09/07/23. An initial complaint visit was conducted on 10/08/21 and subsequent visit was conducted on 06/23/22. During today’s visit, LPA Tao met Administrator Pamela Parsons, and explained the purpose of today's visit, which was to interview residents and re-deliver the investigation findings of the above-mentioned allegations.

The investigation consisted of the following: interviews with Staff #1 (S1) through Staff #6 (S6); interviews with Resident #1(R1) through Resident #11 (R11); attempted to interview resident #12 (R12) and resident#13 (R13), reviews of resident #1’s facility records and a tour of the physical plant. LPA obtained copies of the staff/resident rosters; copies of In-Service Training (Insulin Administration) Records, Pest Control Service Agreement, and Pest Control Company Invoices; and resident #1(R1)’s file for review of relevant information. (-continued in LIC 9099 C-)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Bonnie Tao	TELEPHONE: (323) 981-3971
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

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 28-AS-20211004122114

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: ARCADIA GARDENS RETIREMENT HOTEL	FACILITY NUMBER: 197606145
	VISIT DATE: 09/07/2023

NARRATIVE

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***This licensing report supersedes the original complaint investigation report, dated 06/23/22. The findings remain as Unsubstantiated. ***

In regard to allegation "staff is not dispensing resident's medication as prescribed," it was alleged that staff did not administer resident’s medication and/or insulin as prescribed. Per residents’ interview, eleven (11) out of eleven (11) residents could not corroborate the allegation. Residents interview revealed their medication was administered as prescribed. Per the interviews with residents who were on insulin revealed that staff would check their blood sugar prior administer their insulin and provided proper dosages accordingly. Per staff interviews, six (6) out of six (6) staff denial the allegation. Staff interviews revealed staff would follow the resident’s chart to administer residents’ medication and observe residents when taking the medication. Staff / LVNs would check the resident’s blood sugar between 7:30 a.m. to 8:00 a.m. daily. Night shift LVNs would administer the resident’s medication (Insulin) on Fridays and Saturdays. During the weekday, the morning shift LVN would administer residents’ medication (Insulin). Residents’ blood sugar readings were checked daily and posted in the medication administration record (MAR). The MAR recorded the blood sugar to determine whether the resident’s medication (Insulin) administration was needed. Medication was recorded and documented in the medication computerized system which keeps track of the prescribed medication (Insulin). The medication (Insulin) dosage was determined by the resident's physician. Per the review of residents’ Medication Administration Records (MAR) from 09/01/21 to 09/30/21 and from 10/01/21 to 10/08/21, MAR documented residents had received their blood glucose checks at 7:30 a.m. and at 4:30 p.m. and administered their prescribed medication at 8:00 a.m. Per file reviews, the facility’s in-service training records documented the facility offered training on 08/15/21 to facility LVNs presented by facility’s LVN Director regarding the topic: “Insulin Administration”. Therefore, staff is dispensing resident’s medication as prescribed.

In regard to allegation "staff are not serving a good quality of food", it was alleged that facility did not provide good quality food to residents. Per residents’ interview, nine (9) out of eleven (11) residents could not corroborate the allegation. Residents’ interview revealed the majority of residents corroborated that the facility’s food service is good and there were no issues with the quality of food service. Two (2) out of eleven (11) residents stated the food was not good because it tasted bland or overdone. Per staff interviews, six (6) out of six (6) staff denial the allegation. Staff interviews revealed staff would provide good quality of food and alternate menu was available to residents. (-continued in LIC 9099C-)

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Bonnie Tao	TELEPHONE: (323) 981-3971
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20211004122114

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: ARCADIA GARDENS RETIREMENT HOTEL	FACILITY NUMBER: 197606145
	VISIT DATE: 09/07/2023

NARRATIVE

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***This licensing report supersedes the original complaint investigation report, dated 06/23/22. The findings remain as Unsubstantiated. ***

A virtual tour of the facility’s physical plant was conducted including the kitchen, dining area, food supply; and a review of the facility’s menus showed the facility was all in compliance. During the subsequent visit, LPA/RA Ceniceros conducted a tour with Administrator Parsons to the commercial kitchen, dining room area, and residents’ bedroom to ensure food services were in compliance. LPA Tao toured to the kitchen and observed food were cooked fresh and served hot. Thus, staff is providing good quality food to residents.

In regard to allegation “facility has ants", it was alleged that facility had ants in the facility. Per residents’ interview, ten (10) out of eleven (11) residents could not corroborate the allegation and had not seen ants in their rooms. One (1) resident out of eleven (11) residents said only seen ants when food was left out overnight. Residents’ interview revealed the facility did not have ants issues. Per staff interviews, six (6) out of six (6) staff denial the allegation. Staff interviews revealed staff did not see ants in the facility. During the initial visit conducted by LPA Tao, and subsequent visit conducted by LPA/RA Ceniceros, no ants were observed during the physical plant including facility’s commercial kitchen, dining room area, and residents’ bedroom. As a preventive measure, the facility had a monthly contract with a pest control company that conducts services. Therefore, the allegation of the facility has ants is found to be UNSUBSTANTIATED.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted with Administrator and a hard copy was provided.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Bonnie Tao	TELEPHONE: (323) 981-3971
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

LIC9099 (FAS) - (06/04)

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