197608044-2-24-2022-11-AS-JHAD-CCBRH2-20220308120133

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608044
Report Date: 02/24/2022
Date Signed: 02/24/2022 03:52:37 PM

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
02/16/2022 and conducted by Evaluator Ulysses Coronel

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20220216120820

FACILITY NAME:	VISTA VERANDA ASSISTED LIVING		FACILITY NUMBER:	197608044
ADMINISTRATOR:	NISHITH MODI		FACILITY TYPE:	740
ADDRESS:	3540 MARTIN LUTHER KING, JR.		TELEPHONE:	(310) 638-4113
CITY:	LYNWOOD	STATE: CA	ZIP CODE:	90262
CAPACITY:	178	CENSUS: 98	DATE:	02/24/2022
		UNANNOUNCED	TIME BEGAN:	08:58 AM
MET WITH:	Nishith Modi		TIME COMPLETED:	04:14 PM

ALLEGATION(S):

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Resident's heater is in disrepair.
Staff did not safeguard resident's personal belongings.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ulysses Coronel conducted an initial 10-Day Complaint Investigation visit and met with Nishith Modi, the administrator and the purpose of the visit was explained.

The investigation consisted of the following: On 02/24/2022 LPA and Administrator and measured the air temperature coming from the air-conditioning vents in rooms 1, 10, 76, 165, 167, 175, 177 and 186. LPA interviewed the administrator, 5 staff and 10 out of 72 residents. LPA reviewed and obtained a copy of the facility's resident list and laundry records.

The investigation revealed the following: Regarding the allegation “Resident's heater is in disrepair.”, during today’s visit LPA Coronel and administrator Modi measured the air temperature coming from the air-conditioning vents and the air temperature measured between 69 and 97 degrees Fahrenheit. The administrator showed LPA a mobile phone application which showed that the facility's 4 airconditioning (a/c) units were set to “74” and the a/c unit for the dining area was manually operated by staff.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ulysses Coronel	TELEPHONE: (951) 212-8917
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2022

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-20220216120820

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: VISTA VERANDA ASSISTED LIVING	FACILITY NUMBER: 197608044
	VISIT DATE: 02/24/2022

NARRATIVE

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The administrator stated that the heat is set turn on as soon as the air temperature drops below 74 degrees Fahrenheit and the heat turns off as soon as the temperature reaches 74 degrees Fahrenheit. During interviews 2 out of 5 staff stated that they received complaints from residents that the heaters in their rooms were not working, S2 stated “A resident did complain about the heater before and I told the administrator about it and they told me that they were going to look into it.” 3 out of 5 staff stated they did not receive complains from residents regarding the heater, S5 stated “I check the air-conditioning units almost every day and there are no problems with them. 7 out of 10 residents stated that the heaters in their rooms were working, resident R4 stated “Yes the heater works.” 3 out of 10 residents said the heaters in their room were not working, resident R1 stated “It does not work when I wake up between one and five in the morning and it gets really cold in here.”. Regarding the allegation “Resident's heater is in disrepair.”, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.

Regarding the allegation, “Staff did not safeguard resident's personal belongings.” It is alleged that the resident’s clothes are lost during laundry. On 02/24/2022 LPA Coronel reviewed Vista Veranda’s laundry record and observed that the resident’s clothes are washed at least once a week by the facility’s caregivers. 2 out of 10 residents confirmed that they lost personal belongings during laundry and 7 out of 10 residents denied that they lost personal belongings during laundry. R1 stated “They always return my clothes.” R2 stated “Twice I was given someone else clothes but I gave them back.” R9 stated “Sometimes I lose and sometimes I gain clothes. It was a topic during the past couple of resident council meetings and a suggestion was made for staff to list the number of items they take to laundry so they can check if anything was missing before they return them to us.” Regarding the allegation, “Staff did not safeguard resident's personal belongings.”, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted. A copy of this report was provided to Nisith Modi, administrator.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ulysses Coronel	TELEPHONE: (951) 212-8917
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2022

LIC9099 (FAS) - (06/04)

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