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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197606945
Report Date: 11/15/2024
Date Signed: 11/15/2024 01:11:48 PM

Substantiated


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
11/13/2024 and conducted by Evaluator Noemi Galarza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20241113102148
FACILITY NAME:BROOKDALE CENTRAL WHITTIERFACILITY NUMBER:
197606945
ADMINISTRATOR:SANJAY KABADIFACILITY TYPE:
740
ADDRESS:8101 S PAINTER AVETELEPHONE:
(562) 698-0596
CITY:WHITTIERSTATE: CAZIP CODE:
90602
CAPACITY:92CENSUS: 48DATE:
11/15/2024
UNANNOUNCEDTIME BEGAN:
09:02 AM
MET WITH:Logan Harrison, Interim Administrator TIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Staff do not ensure that resident is provided transportation as agreed to in the Admission Agreement.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Galarza conducted an initial 10-day complaint investigation visit in regards to the allegation listed above. LPA discussed the purpose of the visit with Wellness Director Denise Bartley. Interim Administrator Logan Harrison arrived shortly after.

The investigation consisted of: Record review, physical plant inspection of common areas and parking lot, and interviews with staff (S1-S3) and residents (R1- R7). Copies of R1's Residency Agreement, Admission Record, Physician's Report, Personal Service Plan, DMV Vehicle Registration Renewal Notice, State of CA CHP Safety Compliance Report, resident roster, and staff roster were obtained.
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Noemi Galarza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 28-AS-20241113102148
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: 11/15/2024
NARRATIVE
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Allegation: Staff do not ensure that resident is provided transportation as agreed to in the Admission Agreement. It is alleged that the facility has caused resident (R1) to miss a minimum of six (6) necessary medical appointments in the last 6 months because the facility does not have a staff driver for the facility bus. According to information obtained, facility staff have made transportation arrangements with other Brookdale facilities i.e., Brookdale Uptown Whittier and Brookdale Brea to transport R1 to medical appointments. However, in the past week R1 missed 2 necessary pre-surgery medical appointments. It was reported that due to missed or cancelled appointments due to lack of transportation, R1 has almost lost medical referrals. Non-ambulatory resident (R1) uses a motorized scooter and manual wheelchair, and cannot leave the facility unassisted. It was reported that facility staff told R1 they need to hire somebody to push their wheelchair when they go to doctor appointments. A total of 7 residents were interviewed, of which all stated the facility has a bus but no driver, and transportation has not been offered to residents. The majority of the residents interviewed stated they have had to cancel doctor appointments due to lack of transportation.

A total of three (3) Administration staff were interviewed. They acknowledged the facility has not had a staff person/bus driver to drive the facility bus in over six (6) months. Interim Administrator stated three (3) other sister communities have assisted with R1's transportation in the past. However, due to unavailability and scheduling conflict R1 was not able to be transported by the other sister communities the last week. Staff stated that R1 has been accommodated with transport to most doctor appointments. Due to recent transportation issues, home care agencies that provide transportation and escort assistance have been contacted, but there is no contract is in place yet. Dial-A-Ride is not able to accommodate resident (R1) because the resident uses a large motorized scooter and if the resident uses a manual wheelchair they require staff assistance to push the resident to desired location. According to staff interviews, there are currently five (5) residents that require facility transportation. Based on record review, the Residency Agreement states "We will make available scheduled transportation services as forth in the Addendum of the Residency Agreement." The Addendum To The Residency Agreement Basic Services states "The Community will provide scheduled transportation for shopping and for other errands and planned social events in and around the local area. The Resident Handbook provides additional transportation guidelines." Per Resident Handbook, "Most Communities offer scheduled transportation to stores and doctor appointments within a designated service area." Per observation and record review, this facility has current DMV registration and Safety Compliance Report that indicates all maintenance records are current. The information obtained sufficiently supports the allegation.

Based on record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

An exit interview was conducted with Interim Executive Director Logan . A copy of the report and appeal rights were issued.
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Noemi Galarza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20241113102148
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/13/2024
Section Cited
CCR
87464(f)(6)
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Basic Services. Basic services shall at a minimum include: Arrangements to meet health needs, including arranging transportation, as specified in Section 87465, Incidental Medical and Dental Care Services. This requirement was not met evidenced by:
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Licensee shall ensure the Residency Agreement is adhered to, makes available transportation to medical appointments, and a contingency plan is in place when 3rd party transportation services are not able to transport residents.
Submit a written plan of correction.
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Based on interviews conducted and record review, the findings indicate that resident (R1) missed 2 required pre-surgery appointments during the past week, because the facility did not ensure R1 was transported to appointments via facility bus, sister community transport, Dial-A-Ride, or other alternate arrangement. This poses a potential health and safety risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Noemi Galarza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2024
LIC9099 (FAS) - (06/04)
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