197606145-5-18-2023-28-AS-RORN-CX6RZ8-20231101132732

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197606145
Report Date: 05/18/2023
Date Signed: 05/18/2023 06:31:25 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
05/08/2023 and conducted by Evaluator Bonnie Tao

COMPLAINT CONTROL NUMBER: 28-AS-20230508144515

FACILITY NAME:	ARCADIA GARDENS RETIREMENT HOTEL		FACILITY NUMBER:	197606145
ADMINISTRATOR:	PAMELA PARSONS		FACILITY TYPE:	740
ADDRESS:	720 W. CAMINO REAL		TELEPHONE:	(626) 574-8571
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91007
CAPACITY:	200	CENSUS: 171	DATE:	05/18/2023
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Pamela Parsons, administrator		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Facility does not have enough staff to meet resident care needs.
Contact information of the ombudsman program is not easily accessible to residents and their representatives.
Staff required unlawful changes to resident's insurance from resident's representative.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tao conducted an unannounced 10-day complaint visit to this facility. LPA met with Administrator, Pamela Parsons, who assisted with the visit. LPA explained the purpose of today’s visit was to investigate the above-mentioned allegations.

The investigation consisted of the following: resident interviews, staff interviews, facility tours, and review of facility records. LPA obtained resident roster, staff roster, and residents facility file.

The investigation revealed the following:
In regard to allegation “facility does not have enough staff to meet resident care needs," it was alleged that facility did not have enough staff to help residents to get into bed or take back to residents’ room after eating in the dining room and keep their oxygen cannula not on the floor of residents’ room.

(-continued 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: 05/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/17/2023

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-20230508144515

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: 05/18/2023

NARRATIVE

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Ten (10) out of ten (10) residents interviewed revealed that facility staff had helped residents on getting them into bed, taking them back to their rooms timely and keeping their oxygen cannulas not on the floor. Four (4) out of four (4) staff denied the allegation. Staff interviews revealed that staff would assist residents to meet residents’ care needs. Per LPA’s observation, staff would assist residents to get into bed and take residents to dining room/back to residents' room. Per facility tours and resident interviews, LPA did not see residents’ oxygen cannula were on the floor during the facility tour. After mealtime, staff would take a few residents back to their rooms at a time to prevent traffic jam or congestion in the hallway and elevator. Other residents would remain at the dining room waiting for their turn. Therefore, facility did not show lack of staff to meet residents care needs.

In regard to allegation “contact information of the ombudsman program is not easily accessible to residents and their representatives," it was alleged that facility had no public posting of ombudsman. Ten (10) out of ten (10) residents interviewed could not corroborate the allegation. All four staff interviewed denied the allegation. Per LPA observation, facility had posted the public posting of ombudsman program poster (in size 1.5ft x 2ft) in the lobby next to the resident’s elevator and administrator office. Therefore, facility had posted the contact information of the ombudsman program at the facility’s common area.

In regard to allegation “staff required unlawful changes to resident's insurance from resident's representative," it was alleged that facility was unlawfully changed resident’s health Insurance in mid-May effective June 1st. (-continued LIC 9099 C-)

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Bonnie Tao	TELEPHONE: (323) 981-3971
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20230508144515

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: 05/18/2023

NARRATIVE

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Ten (10) out of ten (10) residents interviewed could not corroborate the allegation. Four (4) out of four (4) staff denied the allegation. Staff interviews revealed that some residents’ insurance agency would end its services with the facility on June 1, 2023. Therefore, staff notified residents/responsible parties about their insurance issues on updating/switching their insurance to another insurance agencies to continue their coverage. Administrator explained that a total of 17 residents’ health insurance would end on May 31, 2023. Therefore, a letter was sent to residents/ responsible parties to notify them regarding the end of the service term of their current health insurance. Facility had provided options to residents on agencies selections and residents could make their decision voluntarily. Per file reviews, that particular health insurance agent would end its service term with the facility in June 2023. Notification letters were provided, and phone calls were made to residents/ residents' responsible parties regarding facility suggestions and residents’ options. Residents have right to make selection of their own. Therefore, staff did not require unlawful changes to resident's insurance from resident's representative.

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

An exit interview was conducted with Administrator. A hard copy of the reports were provided.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Bonnie Tao	TELEPHONE: (323) 981-3971
LICENSING EVALUATOR SIGNATURE:	DATE: 05/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/18/2023

LIC9099 (FAS) - (06/04)

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