197606145-12-11-2021-28-AS-FFIS-C9R4EF-20211215180218

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197606145
Report Date: 12/11/2021
Date Signed: 12/11/2021 11:46:31 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
07/21/2021 and conducted by Evaluator Mary G Flores

COMPLAINT CONTROL NUMBER: 28-AS-20210721121808

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: 184	DATE:	12/11/2021
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Pamela Parsons - Administrator		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff did not assist resident with walking.
Staff did not protect resident's personal items

INVESTIGATION FINDINGS:

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This is a corrected report for report created on 7/28/21 to provide additional information and supersedes report dated 7/28/21.

On 7/28/21 Licensing Program Analyst(s)(LPA) Bonnie Tao conducted an unannounced complaint investigation visit regarding the above allegation(s). LPA Tao met with Pamela Parson administrator and explained the reason for the visit.

The investigation consisted of the following: LPA Tao conducted interview with administrator, resident #1(R1),#2(R2),#3(R3),#4(R4),#5(R5),#6(R6),#7(R7),#8(R8),#9(R9),#10(R10),#11(R11),#12(R12),#13(R13),#14(R14) and staff #2(S2), #3(S3),#4(S4),#5(S5), and contacted family representative for R1. LPA Tao reviewed documents for R1.

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: 12/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2021

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-20210721121808

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: 12/11/2021

NARRATIVE

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The investigation revealed the following: Regarding allegation: Staff did not assist resident with walking. It is alleged staff was requested to walk resident up and down the hall and facility hasn't done that. During interviews with 13 out of 14 residents it was stated staff assist them with walking when they request for assistance and 1 out of 14 was unable to answer due to cognitive skills. During interviews with staff 5 out of 5 staff interviewed stated to assist residents with walking when requested and if the residents show change in condition staff report it to facility's wellness department to obtained further assistance. Administrator stated staff does assist residents that need help and will request physical therapy for those that need more assistance. Documents reviewed revealed R1 does require a walker but no notes on need for physical therapy were observed. R1's responsible party stated R1 is able to walk without assistance.

Based on interviews and documents reviewed the preponderance of evidence has been met, therefore the allegation is found UNSUBSTANTIATED.

Regarding allegation: Staff did not protect resident's personal items. It is alleged that resident's personal items were stolen by staff. During interviews with residents 8 out of 14 residents stated to not have lost or think items might have been stolen from their rooms. 5 out of 14 residents stated to have lost clothes or money at the facility and some reported to the administrator. Interviews with 2 out of 5 staff stated residents usually misplace items and 3 out of 5 staff stated there have not been reports from residents stating to have lost items. Administrator stated residents usually misplaced items and staff looks and will find items in residents' rooms. Documents reviewed for R1 revealed, Resident Personal Property and Valuables revealed the following items do not match the list of missing items. R1's responsible party stated items listed as missing do not belong or have been left in R1's room.

Based on interviews and documents reviewed the preponderance of evidence has been met, therefore the allegation is found UNSUBSTANTIATED.

Exit interview was conducted with Pamela Parsons and a copy of this report was email for signature and provided.

SUPERVISOR'S NAME: Rebecca Orendain	TELEPHONE: (323) 981-3961
LICENSING EVALUATOR NAME: Mary G Flores	TELEPHONE: (323) 981-3965
LICENSING EVALUATOR SIGNATURE:	DATE: 12/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2021

LIC9099 (FAS) - (06/04)

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