197608840-12-1-2023-28-AS-RORN-CY8T45-20231205132323

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608840
Report Date: 12/01/2023
Date Signed: 12/01/2023 10:15:07 AM

Unsubstantiated

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
03/24/2022 and conducted by Evaluator Noemi Galarza

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20220324151805

FACILITY NAME:	BEVERLY HILLS SENIOR CARE		FACILITY NUMBER:	197608840
ADMINISTRATOR:	ANNIE JIANG		FACILITY TYPE:	740
ADDRESS:	1015 S. ORANGE GROVE AVENUE		TELEPHONE:	(323) 933-8271
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90019
CAPACITY:	0	CENSUS: 0	DATE:	12/01/2023
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Patria Dufrene, Licensee		TIME COMPLETED:	10:15 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Resident was sexually abused while in care.
Resident was physically abused while in care.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Galarza conducted a subsequent visit to deliver findings on the investigation conducted by DSS Investigation Branch (IB) Investigator Laarni Santiago. Today’s complaint investigation was conducted telephonically with Licensee Patria Dufrene of New Home For Me, Inc. Note: Facility closed on 12/7/2022. This report will be mailed to the licensee’s last known mailing address and emailed today to Patria Dufrene.

The investigation consisted of the following: On 3/25/2022, a facility tour of 1st, 2nd, 3rd floor, kitchen, dining area, activity room, and lounge was conducted. Resident (R1) was hospitalized at the time of the initial visit. R1's file was reviewed and the following documents were obtained: [identification and Emergency Information, Preplacement Appraisal, Resident Appraisal, Physician Reports, Admission Agreement, Brilliant Corners/Housing for Health enrollment, March 2022 Medication Administration Record, 2 incident reports dated [3/23/22 & 2/11/22], LAPD incident report #, resident roster, staff schedule, and LIC 500 Personnel Report. IB investigator interviewed residents, staff, Department of Health Services LMFT, LAPD, and reviewed medical and law enforcement records.

***Narrative summary continues next page.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi Galarza	TELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023

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 2

Control Number 28-AS-20220324151805

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: BEVERLY HILLS SENIOR CARE	FACILITY NUMBER: 197608840
	VISIT DATE: 12/01/2023

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Allegation: Resident was sexually abused while in care. It is alleged that resident (R1) was sexually assaulted several times by an unknown male at the facility. Investigation revealed that on March 23, 2022, resident (R1) reported to staff that they were raped in the resident’s room in the evening, as well as the night before. Staff that oversaw the same floor that the victim resided in did not see anyone suspicious enter in and out of R1’s room around the time the alleged rape incident took place. There were no witnesses that have come forward to indicate any suspicious activities, including R1’s roommate. Resident (R1) was interviewed and did not disclose sexual abuse and was unable to provide a name or description of the suspect. Furthermore, R1 declined the medical exam and local police closed their case as an injury report since the resident declined to provide information. According to resident (R1’s) case manager, the resident had history of making inconsistent rape allegations in the past. Resident (R1’s) therapist did not believe that the allegations were true. All staff and all residents interviewed had no knowledge of the alleged incident. Therefore, based on evidence gathered there is insufficient evidence to corroborate the allegation.

Allegation: Resident was physically abused while in care. It is alleged that resident (R1) was physically assaulted while in the care of the facility. Investigation revealed that on March 23, 2022, resident (R1) reported to staff that they were physically assaulted in the room in the evening as well as the night before. Staff that oversaw the same floor the resident resided in did not see anyone suspicious enter in and out of resident's rooms around the time of the alleged physical abuse incident. Based on staff and resident interviews there were no witnesses indicating suspicious activities, including R1’s roommate. When resident (R1) was interviewed they did not disclose physical abuse and were unable to provide a name or description of the suspect. Furthermore, R1 declined a medical exam and local police closed their case as an injury report since R1 declined to provide information. Resident (R1’s) therapist did not believe the allegation was true. Therefore, based on evidence gathered, there is insufficient evidence to corroborate the allegation.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations occurred, therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted with Licensee Patria Dufrene. A copy of this report was provided.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi Galarza	TELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 2