197608788-9-8-2022-11-AS-UCOL-CJJNNG-20220923103641

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608788
Report Date: 09/07/2022
Date Signed: 09/08/2022 07:44:13 AM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 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
09/06/2022 and conducted by Evaluator Martessa Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20220906152019

FACILITY NAME:	MERIDIAN AT BELLA MAR		FACILITY NUMBER:	197608788
ADMINISTRATOR:	SHAWN C. MOONEY		FACILITY TYPE:	740
ADDRESS:	825 OCEAN AVE		TELEPHONE:	(310) 393-5258
CITY:	SANTA MONICA	STATE: CA	ZIP CODE:	90403
CAPACITY:	36	CENSUS:	DATE:	09/07/2022
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Anita Csukardi		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff did not maintain a comfortable temperature in the facility

INVESTIGATION FINDINGS:

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On 9/7/22, Licensing Program Analyst (LPA) Martessa Brown conducted an unannounced 24-hour complaint investigation. LPA conducted a covid-19 Risk assessment before entering the building and observed Covid-19 protocols in place. LPA met with Anita Csukardi -Executive Director and explained the purpose of the visit.

The investigation consisted of the following: On 9/7/22, LPA Brown and Executive Director conducted a health/safety check and completed a walk through the entire facility. LPA requested copies of any incidents report pertaining to the allegation. LPA obtained copies of staff and residents rosters and conducted interviews with Executive Director, residents #1-3, #4’s family member and staff members #1-4.

The investigation revealed the following:

Staff did not maintain a comfortable temperature in the facility.

LIC 9099 is on the next page.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Martessa Brown	TELEPHONE: (714) 743-4597
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2022

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-20220906152019

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: MERIDIAN AT BELLA MAR	FACILITY NUMBER: 197608788
	VISIT DATE: 09/07/2022

NARRATIVE

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On 9/7/22, it was alleged that the facility is not maintaining a comfortable temperature in the facility. LPA conducted interviews with Executive Director and staff #1, both stated facilities has a tent cooling Oni located at the top of the courtyard and fans to keep residents cool while doing activities. Both stated there is a cooling system for the facility. The cooling systems for the facility monitors were operated in 2 of the bedrooms that are control the southside and northside of the building on the first floor. Both stated all of the bedrooms have vents that are control by the air-condition units from the 2 bedrooms. LPA interviewed staff #2-4 they stated rooms are a comfortable temperature for residents. LPA conducted interviews with resident #1 the bedroom temperature was warm and #2-3 stated the facility was ok. During today’s visit LPA observed the air conditioning monitors were in a locked cleared box located in 2 bedrooms #1 operates the southside and #2 bedroom operates the northside of the building. Both of the air-conditions were turned off and staff #1 turned on the air-condition units and both temperature readings were 85 degrees at 12:50 PM. Staff and Director was not sure how air-condition units were turned off. LPA observed the dining area and thermometer reading was 85 degrees and fans were located in the area. Based on interviews, observations and records, the director did not ensure the air-conditions were operational and the above allegation is substantiated.

Based on LPAs observations and interviews which were conducted record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be substantiated. California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099D.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Martessa Brown	TELEPHONE: (714) 743-4597
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2022

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20220906152019

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: MERIDIAN AT BELLA MAR	FACILITY NUMBER: 197608788
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/07/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/16/2022 Section Cited CCR 87303(b)	1 2 3 4 5 6 7	87303 Maintenance and Operation (b) A comfortable temperature for residents shall be maintained at all times. This requirement was not met as evidence by:	1 2 3 4 5 6 7	Staff turned on airconditioning units. Executive Director will outline a plan on how to ensure air-condition units and temperature reading are checked and operating at all times to LPAs email address martessa.brown@dss.ca.gov by poc due date.
	8 9 10 11 12 13 14	Based on observation and interview LPA observed the air conditioning monitors located in two bedrooms were off at 12:50 PM. Staff did not ensure air conditioning units were checked and operating. This is a potential health and safety risk to residents 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: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Martessa Brown	TELEPHONE: (714) 743-4597
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2022

LIC9099 (FAS) - (06/04)

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