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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197606945
Report Date: 06/26/2025
Date Signed: 06/26/2025 10:35:57 AM

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
05/12/2025 and conducted by Evaluator Noemi Galarza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20250512091819
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: 51DATE:
06/26/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Mario Preston, Interim Executive DirectorTIME COMPLETED:
10:40 AM
ALLEGATION(S):
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Staff did not ensure resident’s room was adequately cleaned.
Staff did not ensure resident’s room was free from odors.
Staff did not ensure resident’s room was free from pests.
INVESTIGATION FINDINGS:
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*This report supersedes report created on 5/16/2025. It was created to add additional details. Revision does not change complaint findings. Operations Specialist/Interim Executive Director Mario Preston was explained the purpose of the visit.

On 5/16/25, Licensing Program Analyst (LPA) Galarza conducted an initial 10-day complaint investigation visit regarding the above allegations. LPA discussed the purpose of the visit with receptionist. Executive Director Logan Harrison arrived later.

The investigation consisted of: On 5/16/25, a physical plant inspection of common areas and 17 resident rooms was conducted. Staff (S1- S5) and residents (R1- R11) were interviewed. Copies of R1's Admission Record, Physician's Report, Personal Service Plan, resident roster, and LIC 500 Personnel Report were obtained. LPA took photographs during room inspections.
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Noemi Galarza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2025
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 4
Control Number 28-AS-20250512091819
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: 06/26/2025
NARRATIVE
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Allegation: Staff did not ensure resident’s room was adequately cleaned. It is alleged resident (R1's) room is dirty and cluttered due to hoarding. According to information obtained, entrance into the room is blocked. A total of 17 rooms were inspected during today's visit. Two (2) out of the 17 rooms were dirty and cluttered with furniture and personal belongings. On 5/16/25, Licensing Program Analyst (LPA) inspected R1's room and observed many dead cockroaches, several alive cockroaches, old discarded food on the floor, pet hair, dirty floors, trash throughout the room, and bathroom bathtub full of clothing. According to staff interviewed, staff attempt to clean the resident's room but the resident refuses. Staff stated that housekeeping staff clean resident rooms once a week, and caregivers take out the trash daily every shift. A total of 11 residents were interviewed, of which one (1) stated staff do not clean their room. None of the other residents had concerns. Resident (R1) stated they do not know why staff do not clean their room, but then acknowledged they refuse to allow staff to clean. Per Personal Service Plan dated 5/13/2025, facility staff have not assisted R1 with cleaning, picking up trash, putting clothes away, or dusting floor to remove dog hair. There is sufficient evidence to corroborate the allegation.

Allegation: Staff did not ensure resident’s room was free from odors. It is alleged that resident (R1) has a dog in the room that defecates and urinates in the room and there is a "stench" that is smelled from the hallway when the door is opened. Housekeeping and caregiver staff stated R1's pet dog urinates and defecates in the room and confirmed bad odors. According to staff interviews, when the resident moved in pet services were in place, but R1 was able to take the dog out to potty. Therefore, pet services were stopped. Per facility's pet policy when pet services are in place caregivers walk the pet and clean up after the pet(s). Resident (R1) stated their room does not smell like dog feces or urine. None of the 11 residents interviewed stated their rooms have a strong odor. Based on R1's observations of R1's room, a strong odor of urine and feces was smelled. Based on document review, R1's Personal Service Plan "Pet Care" Resident has a dog and needs pet care assistance. Staff are to take dog for walks daily around 8AM, 12 noon, 4 PM, and 8 PM. Staff will monitor pet to see that they are provided adequate food and water. Although, pet services were stopped, in the updated Personal Service Plan dated 5/13/25 it was noted that staff will assist with pet care. Therefore, there is sufficient evidence to support the allegation.
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Noemi Galarza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 28-AS-20250512091819
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: 06/26/2025
NARRATIVE
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Allegation: Staff did not ensure resident’s room was free from pests. It is alleged resident (R1's) is infested with cockroaches and the facility has not addressed the issue. Four (4) out of the 11 residents interviewed stated they have seen cockroaches in their rooms. Resident (R1) stated there are cockroaches "everywhere in my room", but did not report it to Administration staff. A total of 5 staff were interviewed, of which all stated that they did not have knowledge of the cockroach infestation until this week. According to staff interviews, on Tuesday, May 13, 2025, staff went in to R1's room to remove the bed an observed the infestation of cockroaches under the bed. On Wednesday, May 14, 2025, Administration staff called Dewey Pest Control for services. During today's visit, Dewey Pest Control was observed addressing the problem in R1's room. LPA reviewed pest control service contract. They are scheduled to provide services twice a month and/or as needed. Record review revealed that the facility has on-going pest control services in place that focus on common areas, kitchen/dining room, and resident rooms identified in need of pest control mitigation. However, R1's room was not being treated by pest control despite housekeeping staff insight of room uncleanliness i.e. pet food waste. The first pest control room treatment was conducted on 5/16/25.
Based on observation, photo evidence, and interviews, there is sufficient evidence to corroborate the allegation.

Based on observation and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED.

An exit interview was conducted with Interim Executive Director/Operation Specialist Mario Preston. 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: 06/26/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 28-AS-20250512091819
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: 06/26/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/26/2025
Section Cited
CCR
87303(a)
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Maintenance and Operation. The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
This requirement was not met evidenced by:
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Executive Director Harrison agreed to submit a written plan of correction, proof of staff in-service training, pest control service plan for R1's room., and picture proof evidence that R1's room was cleaned.

Proof of completed plan of correction was submitted.
*Citation is cleared.
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Based on observation, resident (R1's) room is infested with cockroaches. During 5/16/25 visit the room had dead and alive cockroaches, maggots, unswept floors, food on the floor/tables, clutter, and excessive amounts of personal belongings on the floor. This poses a potential health and safety risk to persons in care.
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Type B
06/26/2025
Section Cited
CCR
87303(f)
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Maintenance and Operation. All waste shall be located, stored, and disposed of in a manner that will not transmit communicable diseases or odors, pose a risk to health and safety, or provide a breeding place or food source for insects or rodents. This requirement was not met evidenced by:
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Executive Director Harrison agreed to conduct staff training in regulation 87303, and pet services job responsibilities for applicable staff.

Proof of completed plan of correction was submitted.
*Citation is cleared.
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Based on physical plant observation and interviews conducted on 5/16/25, R1's room had a strong odor of pet feces and urine. Pet feces was observed in the patio area and pet urine was on R1's room and temporary room. 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: 06/26/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/26/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4