197606945-3-23-2023-28-AS-RORN-CQCKTK-20230328081113

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197606945
Report Date: 03/23/2023
Date Signed: 03/23/2023 03:31:35 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
04/22/2021 and conducted by Evaluator Alma Gonzalez

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20210422100840

FACILITY NAME:	BROOKDALE CENTRAL WHITTIER		FACILITY NUMBER:	197606945
ADMINISTRATOR:	STEVEN SCIURBA		FACILITY TYPE:	740
ADDRESS:	8101 S PAINTER AVE		TELEPHONE:	(562) 698-0596
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90602
CAPACITY:	92	CENSUS: 53	DATE:	03/23/2023
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Executive Director Barbara Tyler		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Resident is not getting assistance with showers as needed.
Residents do not have grab bars in showers.
Facility did not ensure soiled towels were cleaned in a timely manner.
Facility is not safeguarding resident's belongings.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alma Gonzalez conducted a subsequent complaint visit to deliver investigation findings for the above stated allegations. LPA met with Executive Director Barbara Tyler and explained the reason for the visit.

The investigation consisted of: During the initial visit conducted on 04/27/21, LPA interviewed Resident 1 (R1), Executive Director Barbara Tyler and Health & Wellness Director Amy Rogers. LPA conducted a virtual tour of the following resident bathrooms: Rooms 121, 217, 219, 221 and facility shower room. LPA requested/ received copies of Staff/ Resident Roster and the following documents for R1: Functional Capability Assessment, Appraisal/Needs and Services Plan, Physician’s Report, Admission Agreement, R1's Care Plan and copy of Resident's shower schedule. On 3/23/23, LPA collected copies of staff and resident rosters and conducted interviews with Staff 1-3 (S1-3), and Residents 2-5 (R2-5). LPA reviewed 4 Resident files and collected copies of facility documents relevant to the investigation.

(See LIC9099C for continuation)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Alma Gonzalez	TELEPHONE: (323) 981-3973
LICENSING EVALUATOR SIGNATURE:	DATE: 03/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023

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-20210422100840

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: BROOKDALE CENTRAL WHITTIER	FACILITY NUMBER: 197606945
	VISIT DATE: 03/23/2023

NARRATIVE

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Investigation revealed the following: Regarding allegation, Resident is not getting assistance with showers as needed, it is alleged that R1 pays for assistance with two showers a week and is not getting the assistance. Interviews conducted with 5 out of 5 staff confirmed that residents who require shower assistance are accommodated according to their scheduled shower days. Executive Director, and Health & Wellness Director Amy Rogers stated that R1 is given showers twice a week on Tuesdays and Fridays. They indicated that when R1 refuses or asks staff to come back at a later time, staff will ensure to go back and assist R1 with a shower. If R1 refuses to shower it is properly documented. 5 out of 5 staff stated that if a resident refuses a shower, the refusal will be documented and staff will go as far as even offering a shower to a resident that refused the following day, even if it is not their scheduled shower day. Staff stated they always shower residents per their schedule and/ or if they had an accident, they will give residents an extra shower to make sure they are clean. 3 out of 5 residents stated they get showered twice a week and staff always give them a shower on their shower day. 1 resident stated that they are independent and do not require shower assistance and 1 resident stated that staff are not following their shower schedule. LPA review of the shower schedule revealed that it is clearly outlined which residents are in need of shower assistance and on which days of the week the services are provided. Based on interviews conducted with facility staff, facility residents, and LPA record review, there was not enough supportive evidence to concur with the reported allegation.

For allegation, Residents do not have grab bars in showers, it is alleged that there are no grab bars in R1's room (#121) to assist them with getting into the shower and that there might be other residents who have the same issue in their bathrooms. LPA inspected the following rooms including bathrooms: 121, 217, 219, 221. LPA also inspected the facility shower room which is used to shower some residents if a larger shower space is needed. All resident rooms were observed to be clean and sanitary, bathrooms contain showers with grab bars. LPA also observed a bath chair in Room 121. LPA additionally observed that there is a grab bar in facility shower room. Based on LPA observations, there was not enough supportive evidence to concur with the reported allegation.

For allegation, Facility did not ensure soiled towels were cleaned in a timely manner, it is alleged that there was an incident where R1 discovered three hand towels sitting on top of the shower chair and the towels were covered in feces. R1 reported the incident to facility staff and staff was supposed to take care of it but the towels sat in the bathroom for three days before anything was done about it. Interviews conducted with 5 out of 5 facility staff revealed that laundry service which includes bath towels and hand towels is

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Alma Gonzalez	TELEPHONE: (323) 981-3973
LICENSING EVALUATOR SIGNATURE:	DATE: 03/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20210422100840

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: BROOKDALE CENTRAL WHITTIER	FACILITY NUMBER: 197606945
	VISIT DATE: 03/23/2023

NARRATIVE

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provided to residents on a weekly basis. Interviews conducted with 5 out of 5 residents revealed that laundry services are provided on a weekly basis. 1 resident stated that they had not had concerns about the laundry service except for the incident with the soiled hand towels. They stated that it seemed as if someone used the hand towels as toilet paper. 5 out 5 staff stated that staff would not leave soiled towels in a resident room. They stated that all soiled clothing or hand towels, if any, are immediately taken out of a resident's room and taken to the laundry room to be cleaned immediately. LPA review of the laundry schedule clearly outlines laundry services provided to residents and on which date it is provided. Based on interviews conducted with facility staff and residents, and LPA record review, there was not enough supportive evidence to concur with the reported allegation.

For allegation, Facility is not safeguarding resident's belongings, it is alleged that someone possibly wandered into R1's room when the soiled hand towels were left behind in resident bathroom. Interviews conducted with facility staff revealed that there have been no recent reports from any resident or from R1 about someone wandering into their bathroom and leaving soiled hand towels. Staff stated that they would never leave soiled towels in a resident's room for days before removing them. Executive Director stated that R1 is very particular about who goes into their room when they are not in there. She stated that R1 always ensures that their room is locked when they come out of their room. Interviews conducted with 5 out of 5 facility staff revealed that laundry service which includes bath towels and hand towels is provided to residents on a weekly basis. Interviews conducted with 5 out of 5 residents revealed that laundry services are provided on a weekly basis. 1 resident stated that they had not had concerns about the laundry service except for that incident with the soiled hand towels They stated that it seemed as if someone used the hand towels as toilet paper. 5 out 5 staff stated that staff would not leave soiled towels in a resident room. They stated that all soiled clothing or hand towels, if any, are immediately taken out of a resident's room and taken to the laundry room to be cleaned immediately. Staff also stated that all resident's belongings are safeguarded and stated that residents are encouraged to report any missing items to staff so that they can properly address the situation. Based on interviews conducted with facility staff and residents, there was not enough supportive evidence to concur with the reported allegation.

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.

Exit interview held. A copy of the report was provided to Executive Director Barbara Tyler.

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Alma Gonzalez	TELEPHONE: (323) 981-3973
LICENSING EVALUATOR SIGNATURE:	DATE: 03/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/23/2023

LIC9099 (FAS) - (06/04)

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