197607366-8-8-2022-11-AS-EMAZ-CHMW2Y-20220825165508

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197607366
Report Date: 08/08/2022
Date Signed: 08/08/2022 03:48:37 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 DR #100
MONTERY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/23/2022 and conducted by Evaluator Stephanie Cifuentes

COMPLAINT CONTROL NUMBER: 11-AS-20220223123952

FACILITY NAME:	GARDENA RETIREMENT CENTER		FACILITY NUMBER:	197607366
ADMINISTRATOR:	SUSANA FUENTES		FACILITY TYPE:	740
ADDRESS:	14741 S. VERMONT AVE.		TELEPHONE:	(310) 327-4091
CITY:	GARDENA	STATE: CA	ZIP CODE:	90247
CAPACITY:	108	CENSUS: 68	DATE:	08/08/2022
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:			TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff leaves resident in soiled diapers
Staff do not answer call bells timely
Staff did not meet residents hygiene needs
Staff left resident in bed
Staff did not provide lunch to resident
Staff is rough with resident
Staff do not assist resident
Facility does not have sufficient staff to meet residents needs

INVESTIGATION FINDINGS:

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On 8/8/2022 Licensing Program Analyst (LPA) Stephanie Cifuentes conducted an unannounced subsequent complaint investigation at the facility listed above. LPA arrived at facility and was greeted by Office Manager Christina Novoa. LPA explained the purposed of the visit is to deliver findings on the allegations listed above and was grated entry.

The investigation consisted of the following:
On 2/24/2022 LPA Cifuentes toured facility grounds, reviewed facility files and interviewed staff 1-staff 4 (S1-S4) and resident 1(R1). On 8/8/2022 LPA Cifuentes spoke with staff 5-staff 7(S5-S7) and residents 2-resident 7 (R2-R7). LPA requested and received the following files: Staff roster, resident roster and other documents relevant to the investigation.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7763
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2022

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 11-AS-20220223123952

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 DR #100
MONTERY PARK, CA 91754

FACILITY NAME: GARDENA RETIREMENT CENTER	FACILITY NUMBER: 197607366
	VISIT DATE: 08/08/2022

NARRATIVE

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INVESTIGATION REVEALED THE FOLLOWING:
Allegation: Staff leaves resident in soiled diapers

The complainant alleges that facility residents are often left in soiled diapers. LPA spoke to facility administrator who stated caregivers have a list of the residents that need changes and as the changes are completed they ae marked off on list. No one has missed changes but there are times that residents refuse and ask staff to come by later. LPA spoke with residents (R1-R7) regarding the allegations. Of those interviewed 5 out of 7 stated staff did not leave them in soiled diapers. LPA spoke with staff (S1-S7) regarding allegations. Of the staff questioned, 7 out of 7 stated residents are not left in soiled diapers.

Based on information gathered, the department did not find sufficient evidence to support allegation " Staff leaves resident in soiled diapers”

Allegation: Staff do not answer call bells timely

The complainant alleges that when staff are called for assistance they take a long time to answer. LPA spoke to facility staff, who stated call system is answered by office manager, who then directs caregivers to assist residents as needed. If caregivers are busy with other residents, residents are asked to standby and that staff will be with them shortly. LPA interviewed residents (R1-R7) regarding allegation. Of the residents interviewed 5 out of 7 stated call button was answered promptly. Some residents added that the time it took caregivers to get to room varied, sometimes it was immediate, sometimes it took longer. Of the staff interviewed, 7 out of 7 stated the facility staff answered call button timely, but caregiver response to room varied depending on tasks already being completed.

Based on information gathered, the department did not find sufficient evidence to support allegation “Staff do not answer call bells timely

Allegation: Staff did not meet resident’s hygiene needs

The complainant alleges that staff do not assist residents with changing and grooming. LPA spoke to administrator who stated residents are assisted with changing and grooming daily unless they request to stay in bed. LPA spoke with residents (R1-R7) regarding the allegations. Of those interviewed 6 out of 7 stated staff were assisting with bathing and grooming if they needed assistance. LPA interviewed staff (S1-S7) regarding allegation. 7 out of 7 staff stated that residents are assisted with changing and grooming with some staff adding that some residents may request to be left in bed if they are tired.

Based on information gathered, the department did not find sufficient evidence to support allegation " Staff did not meet residents hygiene needs.”

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7763
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2022

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20220223123952

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 DR #100
MONTERY PARK, CA 91754

FACILITY NAME: GARDENA RETIREMENT CENTER	FACILITY NUMBER: 197607366
	VISIT DATE: 08/08/2022

NARRATIVE

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Allegation: Staff left resident in bed

The complainant alleges staff leave residents in bed all day instead of putting them in wheelchair. LPA spoke to administrator Susana Fuentes who stated residents are not left in bed by staff unless they request to be left in bed. Administrator added that some residents will request to be moved from bed later and staff will assist. There is an occasional delay if the resident requires a two person assist or staff are occupied with other residents. LPA spoke with residents (R1-R7) regarding the allegations. Of those interviewed 5 out of 7 stated they were not left in bed by staff. LPA interviewed staff (S1-S7) regarding allegation. 7 out of 7 staff stated that residents are not left in bed all day.

Based on information gathered, the department did not find sufficient evidence to support allegation " Staff left resident in bed.”

Allegation: Staff did not provide lunch to resident.

The complainant alleges residents are not provided lunch by staff. LPA spoke with administrator, who stated residents are provided 3 meals and snacks. If a resident is not in dining room, they will be called by staff. Residents will at times go out to eat and let staff know they will not be attending meals LPA spoke with residents (R1-R7) regarding the allegations. Of those interviewed 6 out of 7 stated facility did not miss any of their meals with some adding that they sometimes notified facility staff if they wanted to skip a meal. LPA interviewed staff (S1-S7) regarding allegation. 7 out of 7 staff stated residents are provided all meals.

Based on information gathered, the department did not find sufficient evidence to support allegation " Staff did not provide lunch to resident.”

Allegation: Staff is rough with resident.

The complainant alleges staff handle residents roughly when changing them. LPA spoke with staff who stated they are not rough with residents, but that some residents can be rough with staff members. LPA spoke with residents (R1-R7) regarding the allegations. Of those interviewed 6 out of 7 stated staff were not rough with them. LPA interviewed staff S1-S7 regarding allegation. 7 out of 7 staff stated that staff are not rough with residents when assisting them.

Based on information gathered, the department did not find sufficient evidence to support allegation " Staff is rough with resident.”

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7763
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2022

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 11-AS-20220223123952

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 DR #100
MONTERY PARK, CA 91754

FACILITY NAME: GARDENA RETIREMENT CENTER	FACILITY NUMBER: 197607366
	VISIT DATE: 08/08/2022

NARRATIVE

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Allegation: Staff do not assist resident

The complainant alleges staff do not help residents. Per interview with administrator, all residents receive assistance from staff. Administrator added that sometimes residents will be agitated and, in those cases, staff will let them know they will give them time and will come back after a few minutes. Facility will change staff when this happens, as a different face can assist the resident in becoming calmer. LPA spoke with residents (R1-R7) regarding the allegation. Of those interviewed 6 out of 7 staff assisted them when they requested assistance. LPA interviewed staff (S1-S7) regarding allegation. 7 out of 7 staff stated they assisted residents.

Based on information gathered, the department did not find sufficient evidence to support allegation " Staff do not assist resident

Allegation: Facility does not have sufficient staff to meet residents needs

The complainant alleges facility has a staffing shortage. LPA spoke with facility administrator, who stated they had enough staff on all shifts. LPA reviewed staff schedule LPA spoke with residents (R1-R7) regarding the allegations. Of those interviewed 5 out of 7 stated they believed facility needed more staff. LPA interviewed staff (S1-S7) regarding allegation. Of those interviewed, 4 out of 7 believe facility has enough staff.

Based on information gathered, the department did not find sufficient evidence to support allegation " Facility does not have sufficient staff to meet residents needs”

The Department’s investigation consisted of an inspection of the facility, observation, analysis of facility records and interviews conducted and found no evidence to support the allegations: " Staff leaves resident in soiled diapers, “Staff do not answer call bells timely,” “Staff did not meet residents hygiene needs,” “Staff left resident in bed,” “Staff did not provide lunch to resident,” “Staff is rough with resident,” “Staff do not assist resident,” “Facility does not have sufficient staff to meet residents needs.”

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations, did or did not occur, therefore the allegations are Unsubstantiated.

An exit interview was conducted with Susie Fuentes and a hard copy was provided.

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7763
LICENSING EVALUATOR SIGNATURE:	DATE: 08/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/08/2022

LIC9099 (FAS) - (06/04)

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