197606945-7-27-2022-28-AS-LHIS-CHBR6B-20220815124426

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197606945
Report Date: 07/27/2022
Date Signed: 07/27/2022 01:36:10 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
07/22/2022 and conducted by Evaluator Noemi Galarza

COMPLAINT CONTROL NUMBER: 28-AS-20220722115926

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: 56	DATE:	07/27/2022
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Barbara Tyler, Executive Director		TIME COMPLETED:	01:40 PM

ALLEGATION(S):

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Unlawful eviction.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Galarza conducted an initial 10-Day complaint visit to investigate the above allegation.The purpose of the visit was discussed with Executive Director Barbara Tyler.

The investigation consisted of: A physical tour of the facility, and resident (R1's) room was conducted. Staff (S1-S6) and Residents (R1- R5) were interviewed. Resident (R1's) file documents [Admission Record, Identification and Emergency Information, Residency Agreement, Resident Appraisal, Physician Report, Personal Service Plan, progress notes, two (2) incident reports (5/28/22 & 6/9/22), Termination Notice (eviction letter) dated 6/9/22, staff roster, and resident rosters were reviewed and obtained.

See LIC 9099C for report continuation.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi Galarza	TELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2022

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-20220722115926

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: 07/27/2022

NARRATIVE

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Allegation: "Unlawful Eviction." It is alleged that on 6/9/22 resident (R1) was issued a 30-day eviction notice that is unlawful because it lists the reason for eviction as heavy alcohol drinking in the resident's private room. Based on interviews conducted the findings indicate that resident (R1) has lived at the facility since 2015, and has history of excessive consumption of alcohol; which violates the facility Residency Agreement. In 2021, there were seven (7) incident reports pertaining to excessive intoxication, of which 3 resulted in hospitalization. The most recent incident report dated 5/25/2022, states R1 was admitted to the hospital for alcohol intoxication. Over the course of the resident's time at the facility there have been 20+ incident reports related to excessive alcohol consumption/intoxication that posed a health and safety risk to R1 and other residents in care. All staff interviewed denied the allegation and stated that R1 has long history of alcohol abuse that has resulted in multiple falls and injuries that needed to be addressed by medical personnel. Staff stated that R1's intoxication incidents have infringed upon other resident's rights, and have caused distress and/or anxiety. Resident (R1) was interviewed and acknowledged alcohol abuse that has resulted in injuries while living at the facility. The resident stated it did not think the facility would enforce the eviction, and was a given an extension to stay longer. Residents (R2-R5) were interviewed none had knowledge of R1's eviction notice. As of today, R1 is still residing at the facility because Brookdale gave the resident a courtesy verbal extension to move out by August 11, 2022.

Per Brookdale Senior Living Residency Agreement, page 5. Article II "Your Responsibility and Representations" I. "Rule and Regulation Compliance" 3. "You must not be disruptive, must not create unsafe conditions, and must not be physically and verbally abusive to other residents or staff. In addition, page 7, Article IV. "Term and Termination" C(3) "Your failure to comply with the general policies of the community." is the reason for the thirty (30) days written notice. The Resident Responsibilities/Code of Conduct, #4. "Demonstrating behavior and conduct that does not infringe on the peaceful lodging of other residents" is listed as a resident responsibility.

Although the allegation may have happened or is valid, there are not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

An exit interview was conducted with Executive Director Barbara Tyler. A copy of the report was issued.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi Galarza	TELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:	DATE: 07/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/27/2022

LIC9099 (FAS) - (06/04)

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