197608180-1-28-2025-28-AS-TVAO-DDJR58-20250203114242

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608180
Report Date: 01/28/2025
Date Signed: 01/28/2025 03:58:55 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
01/21/2025 and conducted by Evaluator Alberto Lopez

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250121144404

FACILITY NAME:	SILVERADO SENIOR LIVING - THE HUNTINGTON		FACILITY NUMBER:	197608180
ADMINISTRATOR:	ROCHELLE CARPIO		FACILITY TYPE:	740
ADDRESS:	1118 N STONEMAN AVE		TELEPHONE:	(626) 308-9777
CITY:	ALHAMBRA	STATE: CA	ZIP CODE:	91801
CAPACITY:	62	CENSUS: 54	DATE:	01/28/2025
		UNANNOUNCED	TIME BEGAN:	09:57 AM
MET WITH:	Rochelle Carpio, Administrator and Arienne Ghammangne, Director of Health Services		TIME COMPLETED:	04:07 PM

ALLEGATION(S):

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Facility staff are interfering with residents mail and packages

INVESTIGATION FINDINGS:

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License Program Analyst (LPA) Alberto Lopez made unannounced initial visit to investigate the above allegations. LPA met with Rochelle Carpio, Administrator and Arienne Ghammangne, Director of Health Services and discussed the purpose of the visit.

The investigation consisted of LPA taking a tour of common areas, interviewing six (6) staff (S#1-S#6), six (6) residents (R#1-R#6), Interviewing one (1) witness who is family member, reviewing and obtaining staff and resident rosters, R1 Physician’s Report for Residential Care Facilities for the Elderly (RCFE), Email from POA with medication list and Physician’s Admission orders dated 12/12/2024, POA for Health Care dated 11/12/2022, Physician’s orders dated 01/10/2025 for Super B Vitamin, R1 Information and Emergency information worksheet, R1 Preplacement Appraisal Information dated 12/06/2024, R1 client interest Profile dated 12/06/2024, R1 Resident Emergency/Transfer Information, New Prescription dated 01/06/2025 to increase current prescription signed by Physician electronically, and, R1 Service plan dated 12/23/2024.
(Continued on 9099C)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Alberto Lopez	TELEPHONE: 323-980-4926
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025

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 5

Control Number 28-AS-20250121144404

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: SILVERADO SENIOR LIVING - THE HUNTINGTON	FACILITY NUMBER: 197608180
	VISIT DATE: 01/28/2025

NARRATIVE

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The investigation revealed. Allegation Facility staff are interfering with residents mail and packages. It is alleged that facility staff is opening resident’s mail. LPA interviewed six (6) staff and four (4) of six (6) staff denied the allegation. S3 and S5 stated they do open the resident's packages to make sure residents do not get dangerous items and to inventory the items. LPA interviewed six (6) residents and three (3) of six (6) residents stated that their mail is opened by facility staff. Staff stated they want to make sure the residents do not get a medication or over the counter item that they may be allergic to and that is why they open the mail. Opening the resident’s mail is a clear violation of the resident’s rights. There is enough evidence to substantiate this allegation.
Based on interviews conducted, the preponderance of evidence standard has been met, therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6 and Chapter 8), is being cited on the attached LIC 9099D.

An exit interview was conducted. The Plan of Correction was reviewed and developed with the Administrator. A copy of this report and appeal rights were provided.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Alberto Lopez	TELEPHONE: 323-980-4926
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 28-AS-20250121144404

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: SILVERADO SENIOR LIVING - THE HUNTINGTON	FACILITY NUMBER: 197608180
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/28/2025

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/31/2025 Section Cited CCR 87468.1(a)(15)	1 2 3 4 5 6 7	87468.1 Personal Rights of Residents in All Facilities (a) Residents in all residential care facilities for the elderly shall have all of the following personal rights: (15) To send and receive unopened correspondence in a prompt manner. This requirement has not been met as evidenced by:	1 2 3 4 5 6 7	Administrator will read section 87468.1 and send a written statement to LPA stating she has read and understands the section. Also, facility staff will not open any correspondence belonging to residents and will provide it to residents promptly and unopened.
	8 9 10 11 12 13 14	S3 and S5 stated that resident's correspondence is opened and screened before giving it to resident which poses an immediate risk to the health, safety, or personal rights to the persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Alberto Lopez	TELEPHONE: 323-980-4926
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025

LIC9099 (FAS) - (06/04)

Page: 3 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
01/21/2025 and conducted by Evaluator Alberto Lopez

COMPLAINT CONTROL NUMBER: 28-AS-20250121144404

FACILITY NAME:	SILVERADO SENIOR LIVING - THE HUNTINGTON		FACILITY NUMBER:	197608180
ADMINISTRATOR:	ROCHELLE CARPIO		FACILITY TYPE:	740
ADDRESS:	1118 N STONEMAN AVE		TELEPHONE:	(626) 308-9777
CITY:	ALHAMBRA	STATE: CA	ZIP CODE:	91801
CAPACITY:	62	CENSUS: 54	DATE:	01/28/2025
		UNANNOUNCED	TIME BEGAN:	09:57 AM
MET WITH:	Rochelle Carpio, Administrator and Arienne Ghammangne, Director of Health Services		TIME COMPLETED:	04:07 PM

ALLEGATION(S):

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Facility staff are chemically restraining resident.

INVESTIGATION FINDINGS:

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License Program Analyst (LPA) Alberto Lopez made unannounced initial visit to investigate the above allegation. LPA met with Rochelle Carpio, Administrator and Arienne Ghammangne, Director of Health Services and discussed the purpose of the visit.
The investigation consisted of LPA taking a tour of common areas, interviewing six (6) staff (S#1-S#6), six (6) residents (R#1-R#6), Interviewing one (1) witness who is family member, reviewing and obtaining staff and resident rosters, R1 Physician’s Report for Residential Care Facilities for the Elderly (RCFE), Email from POA with medication list and Physician’s Admission orders dated 12/12/2024, POA for Health Care dated 11/12/2022, Physician’s orders dated 01/10/2025 for Super B Vitamin, R1 Information and Emergency information worksheet, R1 Preplacement Appraisal Information dated 12/06/2024, R1 client interest Profile 12/06/2024, R1 Resident Emergency/Transfer Information, New Prescription dated 01/06/2025 to increase current prescription signed by Physician electronically, and, R1 Service plan dated 12/23/2024.
(Continue on 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Alberto Lopez	TELEPHONE: 323-980-4926
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 4 of 5

Control Number 28-AS-20250121144404

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: SILVERADO SENIOR LIVING - THE HUNTINGTON	FACILITY NUMBER: 197608180
	VISIT DATE: 01/28/2025

NARRATIVE

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(continued from 9099)

The investigation revealed. LPA interviewed six (6) staff and six (6) of six (6) staff denied the allegation. LPA interviewed six (6) residents and six (6) of six (6) residents could not corroborate the allegation. LPA reviewed R1 medication list, and all medications are ordered by R1’s physician and are administered according to physician’s orders. W1 who is POA for health care for R1 is aware and in agreement of the medications facility is providing to R1. LPA observed R1 to be alert during the entire visit. There is insufficient evidence to substantiate this 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 UNSUBSTANTIATED.

An exit interview was conducted with Administrator. A copy of this report along with the appeal rights were provided.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Alberto Lopez	TELEPHONE: 323-980-4926
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2025

LIC9099 (FAS) - (06/04)

Page: 5 of 5