197608180-10-1-2020-28-AS-MVAO-BXUN6P-20210202091125

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608180
Report Date: 09/30/2020
Date Signed: 10/01/2020 04:36:30 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 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
06/26/2020 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20200626145507

FACILITY NAME:	SILVERADO SENIOR LIVING - THE HUNTINGTON		FACILITY NUMBER:	197608180
ADMINISTRATOR:	SAFOORA AHMED		FACILITY TYPE:	740
ADDRESS:	1118 N STONEMAN AVE		TELEPHONE:	(626) 308-9777
CITY:	ALHAMBRA	STATE: CA	ZIP CODE:	91801
CAPACITY:	62	CENSUS: 40	DATE:	09/30/2020
		UNANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:	Safoora Ahmed, Administrator		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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1. Staff did not safeguard resident's personal items.
2. Facility is in disrepair.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent visit to deliver the findings for the allegations listed above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today's complaint investigation was conducted telephonically with Safoora Ahmed (Administrator).

During the initial visit on 7/3/20, LPA Chan obtained copies of the Staff and Resident rosters. LPA Chan conducted interviews with the Administrator, the Director of Health Services, and Staff #1 - #2. LPA conducted interviews with Staff #3 - #5 on 9/3/20. On 9/30/20, LPA interviewed additional 2 Staff and 4 Residents.

Investigation revealed the following:
(Continue on LIC9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Christine Yee	TELEPHONE: (323) 981-3978
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2020

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-20200626145507

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: SILVERADO SENIOR LIVING - THE HUNTINGTON	FACILITY NUMBER: 197608180
	VISIT DATE: 09/30/2020

NARRATIVE

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Allegation – Staff did not safeguard resident’s personal items. It is alleged that the staff did not clean the rooms prior to moving residents into a new room, leaving behind belongings from the past residents. Per Administrator, the rooms are inspected and thoroughly cleaned before moving a resident into a new room. All items belonging to previous residents are either moved to a storage room or family members pick up the items but not left in the room. Staff interviewed also stated that they do not and cannot move a resident to a new room without cleaning the room first. Residents interviewed stated that their rooms were cleaned when they moved in and no items belonging to a previous resident were left there. Based on information obtained from interviews, there is insufficient evidence to corroborate this allegation.

Allegation – Facility is in disrepair. It is alleged that the air conditioning has mold, the air conditioning on the 2^nd floor is leaking, and there is missing lighting throughout the facility. The Administrator stated that the housekeepers wipe down the rooms every day including the air conditioners. She did not notice or hear from others regarding any missing lightings nor leaks from the air conditioners. The maintenance staff indicated that the resident’s rooms are deep cleaned twice a month in which he would wipe down the drawers, thoroughly clean the vents, and check the air conditioner for any leaks. Staff interviewed stated that they have not seen any mold nor leaks on the air conditioners recently and have not noticed any missing lighting. Staff indicated that if there are any maintenance issues at the facility, they would report it to the maintenance staff right away to repair the issue or request service from the vendor. All 4 residents interviewed stated that they have not seen any mold nor leaks in the air conditioners. They also feel that the facility has sufficient lighting. Based on information obtained from interviews, there is insufficient evidence to corroborate this allegation.

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 the Administrator. A copy of this report was sent via email for a signature and a copy of the appeal rights was also provided.

SUPERVISOR'S NAME: Christine Yee	TELEPHONE: (323) 981-3978
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2020

LIC9099 (FAS) - (06/04)

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