197606945-6-22-2023-28-AS-LHIS-CT7MD6-20230627093037

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197606945
Report Date: 06/22/2023
Date Signed: 06/22/2023 04:18:08 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
06/15/2023 and conducted by Evaluator Angelica Rea

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230615172253

FACILITY NAME:	BROOKDALE CENTRAL WHITTIER		FACILITY NUMBER:	197606945
ADMINISTRATOR:	BARBARA TYLER		FACILITY TYPE:	740
ADDRESS:	8101 S PAINTER AVE		TELEPHONE:	(562) 698-0596
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90602
CAPACITY:	92	CENSUS: 52	DATE:	06/22/2023
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Sanjay Kabadi		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Facility evicted resident without assisting with alternative housing and care options.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angelica Rea conducted an initial complaint visit in response to the allegation listed above. LPA met with Executive Director, Sanjay Kabadi and explained the reason for the visit.

Regarding the allegation that, Facility evicted resident #1 without assisting with alternative housing and care options. The investigation consisted of: interview(s) with Executive Director, and,Staff #1. LPA also interviewed Resident #1, and obtained specific documents from Resident #1's file. Resident #1 is no longer living at the facility, effective 6/16/23. LPA interviewed Resident #1 at his new residence.

The investigation revealed the following: Facility staff interviewed stated that Resident #1 was issued an eviction notice on 5/18/23. Staff stated that they did provide resident #1 with assistance with alternative housing and care options. Staff interviewed stated that resident #1 was assisted by staff #1 in making phone calls, and was also provided with a phone to use to make phone calls.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica Rea	TELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023

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-20230615172253

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: BROOKDALE CENTRAL WHITTIER	FACILITY NUMBER: 197606945
	VISIT DATE: 06/22/2023

NARRATIVE

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Executive Director stated that they were able to assist Resident #1 in obtaining new housing through the assistance of resident #1's nurse practitioner, who found resident #1's new housing.

Resident #1 confirmed that he was issued an eviction notice on 5/18/23, and confirmed that the facility staff provided assistance to resident in finding new housing. Resident #1 also confirmed that the nurse practitioner offered assistance in finding his new residence.

Based on LPA's observations and interviews, investigation revealed: 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 was conducted, and a copy of report was provided to Executive Director.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica Rea	TELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2023

LIC9099 (FAS) - (06/04)

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