197608788-2-17-2023-11-AS-SCIS-CU4P3A-20230726105709

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608788
Report Date: 02/17/2023
Date Signed: 02/17/2023 05:38:35 PM

Unsubstantiated

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
02/10/2023 and conducted by Evaluator Pamela Bunker

COMPLAINT CONTROL NUMBER: 11-AS-20230210085308

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: 2	DATE:	02/17/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Anita Csukardi		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Staff are not providing adequate food service to residents
Staff do not keep the facility clean
Staff leave the resident in bed for a prolonged period of time
Staff are not meeting the resident's incontinence needs
Licensee lacks the financial resources to meet the resident's needs

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint visit on Friday, February 17, 2023. Upon arrival at the facility. LPA Bunker called the facility via telephone and conducted a Risk Assessment. Based on the assessment, the facility is cleared of COVID-19 infection. LPA Bunker met with Executive Director Anita Csukardi. LPA Bunker explained the purpose of today's visit.

The investigation consisted of the following: Interviews conducted with staff 1-3 (S1-S3) and residents 1-2 (R1-R2). LPA Bunker asked questions relevant to the nature of the complaint. Ms. Csukardi and LPA Bunker toured the buildings and grounds to observe and identify any signs of neglect, abuse, or other immediate health and safety threats. We did not observe any signs of neglect or abuse during today's visit. LPA Bunker requested and reviewed resident 1's (R1) records and requested copies of supporting documents.

See continued LIC9099-C page 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Pamela Bunker	TELEPHONE: (323) 213-1113
LICENSING EVALUATOR SIGNATURE:	DATE: 02/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2023

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-20230210085308

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: 02/17/2023

NARRATIVE

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Continued LIC812-C page 2

Allegation #1: Staff are not providing adequate food service to residents
Staff 1-3 (S1-S3) and residents 1- 2 (R1-R2) were interviewed and stated the facility currently has two (2) residents in placement and both residents are provided adequate food service. S1-S3 and R1-R2 stated residents are getting plenty of food to eat, three (3) meals per day plus snacks, breakfast, lunch, dinner, and snacks daily. S1-S3 and R1-R2 stated staff serves residents hot meals. S1-S3 and R1-R2 stated denied the allegation.

Allegation #2: Staff do not keep the facility clean
Staff 1-3 (S1-S3) and residents (R1-R2) interviewed stated the facility is cleaned daily. We toured the facility during the visit we observed the facility to be clean, safe, sanitary, and in good repair for the safety and well-being of clients, employees, and visitors. S1-S3 and R1-R2 denied the allegation.

Allegation #3: Staff leave resident in bed for a prolonged period of time
Staff 1-3 (S1-S3) and residents (R1-R2) stated residents are not left in bed for a prolonged period of time. S1-S3 and R1-R2 stated staff is constantly checking on residents. S1 stated residents have a right if they don't want to leave their rooms. Staff 1-3 and R1-R2 stated staff is always available to assist residents and the facility has three (3) different shifts that assist with staffing 24 hours a day, 7 days a week, 365 days a year until March 03, 2023. S1-S3 and R1-R2 denied the allegation.

Allegation #4 Staff are not meeting resident's incontinence needs
Staff 1-3 (S1-S3) and residents (R1-R2) stated staff is meeting the resident's incontinence needs. S1-S3 stated residents are good at telling staff when they need to go to the bathroom and staff constantly checks on residents. S1-S3 and R1-R2 denied the allegation.

Allegation #5 Licensee lacks financial resources to meet the resident's needs
Staff 1-3 (S1-S3) and residents (R1-R2) interviewed stated the facility has an ample supply of everything, food, cleaning supplies, the telephones are operable and working, etc. S1 state the bills are paid and nothing has been shut off. S1 stated the facility is not lacking financial resources to meet the resident's needs. S1-S3 and R1-R2 denied the allegation. See continued LIC9099-C page 3

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Pamela Bunker	TELEPHONE: (323) 213-1113
LICENSING EVALUATOR SIGNATURE:	DATE: 02/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20230210085308

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: 02/17/2023

NARRATIVE

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Continued LIC812-C page 2

Investigation revealed the following: Staff 1-3 (S1-S3) and residents R1-R2 interviewed stated the allegations are all false. LPA Bunker was informed by Executive Director Anita Csukardi there are currently two (2) residents in placement. The facility Meridian at Bella Mar had a Zoom meeting with Community Care Licensing Division (CCLD), Regional Manager (RM) Benita Yates, and Licensing Program Manager (LPM) Ulysses Coronel informing the department of the facility closure. Ms. Csukardi stated the residents received advance notice and a letter on January 02, 2023, that Meridian at Bella Mar is closing on March 03, 2023, as of today, all the residents have moved out except two (2) residents. Ms. Csukardi stated the facility has reached out to R1's conservator via telephone and email several times to assist with making new placement arrangements. LPA Bunker spoke to the conservator via telephone and she stated she is working on finding another facility for R1. S1-S3 and R1-R2 stated the facility has adequate food service. During today's visit, Executive Director Ms. Csukardi and LPA Bunker observed an ample supply of nonperishable foods for a minimum of one week and fresh perishable foods for a minimum of two days. S1-S2 and R1-R2 interviewed stated the facility is cleaned daily by housekeeping. We toured the facility it was clean, safe, sanitary, and in good repair at the time of the visit. S1-S3 and R1-R2 stated staff does not leave residents in bed for a prolonged period of time. S1-S3 and R1-R2 stated staff is providing care and supervision necessary to meet the resident's needs. S1-S3 and R1-R2 stated staff ensures that residents who need assistance with incontinence are reminded to go to the bathroom at regular intervals. S1-S3 and R2-R3 stated that staff ensures incontinent residents are checked during those periods of time when they are known to be incontinent throughout the day and during the night. S1-S3 and R1-R2 stated that staff ensures incontinent residents are kept clean and dry and that the facility remains free of odors from incontinence. S1 stated the facility ensures that they have the financial resources necessary to meet operating costs for the care and supervision of residents. S1 stated the facility is not lacking financial resources to meet the resident’s needs. R1-R2 stated they were happy with the staff and the daily care and supervision they are receiving. R1-R2 stated they like living at the facility and had no problems. S1-S3 and R1-R2 denied the allegation.

Based on interviews, available evidence, observation, information received, and records reviewed there was not enough sufficient evidence to support the 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 deemed unsubstantiated.
There were no deficiencies cited. Exit interview conducted.

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Pamela Bunker	TELEPHONE: (323) 213-1113
LICENSING EVALUATOR SIGNATURE:	DATE: 02/17/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2023

LIC9099 (FAS) - (06/04)

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