197606945-4-12-2021-28-AS-MVAO-C5SP2Q-20210811105620

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197606945
Report Date: 04/11/2021
Date Signed: 04/12/2021 11:07:07 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
03/26/2021 and conducted by Evaluator Linda M Almaraz

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20210326141151

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: 70	DATE:	04/11/2021
		UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Barbara Tyler, Executive Director		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff left resident in soiled clothing for extended periods of time
Residents room smells like urine
Resident denied incontinence products

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Linda Almaraz initiated a complaint investigation for the allegations listed above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, this complaint investigation was conducted telephonically with Barbara Tyler, Executive Director.

The investigation consisted of the following: On 4/1/21, LPA Almaraz interviewed Office Manager and Staff #1. LPA requested staff and resident rosters, incontinent residents list and Resident #1's file. On 4/5/21, LPA interviewed Executive Director, Staff #2- 5 and Resident #1. On 4/6/21, LPA continued interviews with Residents #2-9 and requested files for Resident #8 and #9.

The investigation revealed the following: Based on interviews with residents they are changed frequently and are not left soiled for long periods. Per staff interviews, they check on incontinent residents every 2 hours.
**(Continued on LIC 9099-C)**

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Christine Yee	TELEPHONE: (323) 981-3978
LICENSING EVALUATOR NAME: Linda M Almaraz	TELEPHONE: (323) 981-3307
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2021

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 2

Control Number 28-AS-20210326141151

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: 04/11/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Some residents stated if they need to be changed prior to them being checked on, they can call the caregivers and they are changed. Staff interviews also stated they are familiar with residents who need to be changed more frequently than others and they check on those particular residents more often than every 2 hours. Regarding allegation "Staff left resident in soiled clothing for extended periods of time," it is unsubstantiated.

Residents stated they do not have any issues with their rooms smelling like urine. During staff interviews it was revealed there is 1 resident who's room had a smell but not a urine smell. The Executive Director stated this was brought to the facility's attention by the family and although the staff could not smell the odor they provided a deep cleaning of the room. Staff interviews also revealed that in the past, sometimes the residents have strong urine odor but it goes away as soon as they are changed and none of the rooms smell like urine.
Regarding allegation "Residents room smells like urine," it is unsubstantiated.

Based on interviews with staff and residents, no one has been denied incontinent products. Residents who are incontinent have the option to join the facilities "Personal Solutions" program. If residents chose to not enroll in the program they or their Responsible Party is responsible to purchase the products on their own and if a resident is not replenished 2 days before they run out of their products, the facility automatically orders a 2 week supply for the resident and they or their Responsible Party is billed for the supply. During interviews all residents stated if they ask for any products they are provided with what is needed. All staff stated they have never denied any incontinent products to the residents. Regarding allegation "Resident denied incontinence products," it is unsubstantiated.

Based on LPA's interviews conducted and records reviewed, investigation revealed: Although the allegations 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 allegations are unsubstantiated.

No Deficiencies cited under California Code of Regulations Title 22. An exit Interview was conducted via telephone with the Executive Director and a hardcopy was provided via email for signature. Signatures on hardcopy.

SUPERVISOR'S NAME: Christine Yee	TELEPHONE: (323) 981-3978
LICENSING EVALUATOR NAME: Linda M Almaraz	TELEPHONE: (323) 981-3307
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 2