197607718-5-29-2021-11-AS-MCAA-C57TKX-20210723144840

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197607718
Report Date: 03/04/2021
Date Signed: 05/29/2021 09:19:45 AM

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
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/22/2021 and conducted by Evaluator Pamela Bunker

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20210222114035

FACILITY NAME:	CENTINELA ASSISTED LIVING CENTRE		FACILITY NUMBER:	197607718
ADMINISTRATOR:	GWENDOLYN CRAIG		FACILITY TYPE:	740
ADDRESS:	1000 S FLOWER ST		TELEPHONE:	(310) 674-3216
CITY:	INGLEWOOD	STATE: CA	ZIP CODE:	90301
CAPACITY:	96	CENSUS: 43	DATE:	03/04/2021
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Gwen Craig		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Staff are harassing resident
Staff are not following special diet plan

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint tele-visit on Thursday, March 04, 2021, at 9:00 A.M., Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19) Pandemic, and to implement mitigation measures, today’s complaint investigation was conducted telephonically with Administrator Gwen Craig. LPA Bunker explained the purpose of today's tele-investigation.

Investigation consisted of the following: LPA Bunker interviewed four (4) staff 1-4 (S1-S4), and five (5) residents (R1-R5).

Allegation #1: Staff is harassing resident. Staff and residents interviewed stated staff doesn't harass residents. The staff is helpful and assists residents with their daily needs. Residents and staff interviewed did not witness staff harassing any resident. The facility has a zero tolerance policy for harassment.

See continued LIC9099-C page 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Michael Cava
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2021

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-20210222114035

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
MONTEREY PARK, CA 91754

FACILITY NAME: CENTINELA ASSISTED LIVING CENTRE	FACILITY NUMBER: 197607718
	VISIT DATE: 03/04/2021

NARRATIVE

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Continued LIC9099-C page 2

Allegation #2 Staff are not following a special diet. Staff and residents stated if a resident is on a special diet staff is following their physician's orders. Residents and staff stated the facility is providing proper food service. The residents who were interviewed were content with the food that has been served to them. According to residents, they are served three (3) meals per day, plus snacks and their needs are also being met. Staff stated residents are provided adequate food service of good quality. The menus are written at least one week in advance and copies of the menus are posted in the facility dining room, activity room and copies are also, kept on file.

Investigation revealed the following: Interviews were conducted with staff #1- #4 (S1-S4)and residents #2- #5 (R2-R5). During interviews, residents stated that they had no problem with the staff. The staff does not harass residents. Resident stated they are being treated with dignity and respect. Residents stated that they are all happy with how they are treated by the staff. Residents stated if they need assistance with anything staff is available to assist. Residents stated staff provided them with the necessary care and supervision. Staff and residents stated the food is prepared and served according to residents' diet, it is of good quality and quantity to meet the needs of the residents. Staff and residents stated residents are served three (3) meals per day, plus snacks, breakfast, lunch, dinner. The total daily diet has quality and quantity to meet the resident's needs. Menus are made available for review by the residents or their designated representatives and the licensing agency. Modified diets prescribed by a resident's physician as a medical necessity are provided to residents that are on a special diet. Staff and residents interviewed denied allegations.

Based on interviews, available evidence, observation, information received, and records reviewed there was not enough sufficient evidence to support the allegation. Although the allegation 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 allegation is deemed unsubstantiated.

LPA Bunker emailed Administrator Gwen Craig a hard copy via email for the signature of the Complaint Investigation Report LIC9099 and LIC9099-C.

A telephonic exit interview was conducted.

SUPERVISORS NAME: Michael Cava
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 03/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/04/2021

LIC9099 (FAS) - (06/04)

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