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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197607718
Report Date: 08/06/2021
Date Signed: 08/07/2021 09:35:14 PM

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 DR #100
MONTERY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/12/2021 and conducted by Evaluator Lourdes Montoya
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20210712084711
FACILITY NAME:CENTINELA ASSISTED LIVING CENTREFACILITY NUMBER:
197607718
ADMINISTRATOR:GWENDOLYN CRAIGFACILITY TYPE:
740
ADDRESS:1000 S FLOWER STTELEPHONE:
(310) 674-3216
CITY:INGLEWOODSTATE: CAZIP CODE:
90301
CAPACITY:96CENSUS: 49DATE:
08/06/2021
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:GWENDOLYN CRAIGTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Facility staff withheld money from the resident
INVESTIGATION FINDINGS:
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On 8/4/2021, Licensing Program Analyst (LPA) Lourdes Montoya conducted a subsequent unannounced complaint visit to deliver the complaint findings. LPA Montoya called the facility and spoke with Director of Social Services Elizabeth Hernandez to conduct a risk assessment. Based on the assessment, the facility is clear of Covid-19 infection. At around 2:30 pm, LPA Montoya met with Administrator Gwendolyn Craig and explained the purpose of the visit.

The investigation consisted of the following: A tour of the facility and interviews with the administrator, staff, and residents on 7/21/2021 and 7/27/21; review of Resident #1’s admission agreement, physician’s report, Appraisal/Needs and Services Plan, and other facility records pertinent to the allegation above.

REPORT CONTINUED IN LIC 9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Angela J Kendrick
LICENSING EVALUATOR NAME: Lourdes Montoya
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021
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 3
Control Number 11-AS-20210712084711
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: CENTINELA ASSISTED LIVING CENTRE
FACILITY NUMBER: 197607718
VISIT DATE: 08/06/2021
NARRATIVE
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The investigation revealed the following:

Allegation: Facility staff withheld money from the resident.

It is alleged the facility staff withheld money from the resident. Based on record review, the Admission Agreement shows the victim was admitted to the facility on August 14, 2020. Resident #1’s monthly SSI rate for all basic services is $1079.37. The agreement states that if the resident is not able to manage his finances or if he has no conservator, the administrator will manage and supervise his cash resources.

The department attempted to interview eleven residents (#1-#11); nine (9) residents were available, but two (2) residents were not able to provide feedback. Resident (#9) refused to respond, while Resident (#11) was unavailable during the interview.

During the department interview, the administrator (Staff #1) admitted there are 12 residents whose SSI/SSDI payment or private money have been withheld in July 2021 due to the facility’s Check system error and the facility’s inability to produce cash. Staff #1 stated the facility deposits the resident's check(s) and cash it out for them. Staff #1 admitted the facility withheld Resident #1’s checks in the amount of $200 dated June 22, 2021, and $138.00 dated June 23, 2021, from the County of Los Angeles, Public Administration – Public Guardian. Staff #1 stated the facility does not have available cash on hand to give to the residents, and there are no alternatives to obtain cash other than through the RFMS check system. Staff #1 revealed the cash resources of 12 residents payees have been given to them on July 30, 2021. Staff #1 added the facility gave $20.00 cash to Resident #1 on July 23, 2021. The Director of Social Services also admitted there are some residents who were affected by the Check System error, and their SSI/SSDI money has been withheld during July 2021. Residents (#2, #3, #5, #6, #7, and #4) provided feedback to the interviews and stated the facility does not handle their cash resources. Residents #8 and #10 explained the facility handles their cash resources, and they have not received their July SSI/SSDI payments as of July 27, 2021, due to the failure of the facility’s check system. Resident #1, the alleged victim, stated the facility withheld his July SSI payment and private money. Resident #1 was unable to provide the amount of the money owed to him by the facility. Resident #1 received his July SSI payment and private money on July 30, 2021 from the facility. Interviews and records review concur with the above allegation.

Based on LPA’s observations, interviews, and records review, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA observed the following deficiency and issued a citation.

An interview was conducted with Gwendolyn Craig, the Administrator, and a hard copy was provided along with Appeal rights.

SUPERVISORS NAME: Angela J Kendrick
LICENSING EVALUATOR NAME: Lourdes Montoya
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 11-AS-20210712084711
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: CENTINELA ASSISTED LIVING CENTRE
FACILITY NUMBER: 197607718
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/06/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/20/2021
Section Cited
CCR
87217(h)
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This report is being amended to correct the Section Number cited in Title 22.

87217 Safeguards for Resident Cash, Personal Property, and Valuables (h) Immediately upon admission, residents' cash resources entrusted to the licensee and not kept in the licensed facility shall be deposited in any type of bank, savings and loan or credit union account, which is maintained separate from the personal or business accounts of the licensee, provided that the account title clearly notes that it is residents' money and the resident has access to the money upon demand to the licensee. This requirement is evidenced by:
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Licensee gave the twelve (12) resident payees their July SSI/SSDI/private money in cash on July 30, 2021. This was corrected prior to this visit.
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Based on observation, records review and interviews, The administrator admitted twelve (12) residents including Resident #1 were affected by the Check system error and facility was not able to release their cash resources for July 2021 until July 30, 2021. The facility withheld Resident #1's monies in the amount of $200 dated June 22, 2021, and $138.00 dated June 23, 2021, from the County of Los Angeles, Public Administration – Public Guardian. Staff #1 stated the facility does not have available cash on hand to give to the residents, and there are no alternatives to obtain cash other than through the RFMS system. This poses a potential Health, Safety and/or Rights risk to residents 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.
SUPERVISORS NAME: Angela J Kendrick
LICENSING EVALUATOR NAME: Lourdes Montoya
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3