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Department of
SOCIAL SERVICES
Community Care Licensing
COMPLAINT INVESTIGATION REPORT
Facility Number:
197608907
Report Date:
08/02/2022
Date Signed:
08/02/2022 12:06:20 PM
Unsubstantiated
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office
,
21731 VENTURA BLVD., STE. 250
WOODLAND HILLS
,
CA
91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/23/2022
and conducted by Evaluator
Wendell Smith
COMPLAINT CONTROL NUMBER:
31-AS-20220523171448
FACILITY NAME:
COMPASSIONATE ELDERLY CARE MANAGEMENT SYSTEMS, INC
FACILITY NUMBER:
197608907
ADMINISTRATOR:
CELIA T. OYIBU
FACILITY TYPE:
740
ADDRESS:
44161 11TH ST. W
TELEPHONE:
(661) 317-7354
CITY:
LANCASTER
STATE:
CA
ZIP CODE:
93534
CAPACITY:
6
CENSUS:
2
DATE:
08/02/2022
UNANNOUNCED
TIME BEGAN:
09:30 AM
MET WITH:
Charles Oyibu
TIME COMPLETED:
12:10 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Adequate food service is not provided to residents
Staff does not follow food menu for residents
Staff not meeting residents dietary needs
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Wendell Smith conducted an unannounced subsequent complaint visit to investigate the allegation above. LPA met with the administrator and explained the reason for this visit.
LPA conducted a physical plant tour to ensure no immediate health and safety issues and none were noted during the tour.
Adequate food service is not provided to residents
It is alleged that the food served is not of good quality. Previous visit was conducted on 5/27/22 where interviews were conducted. During today's visit LPA interviewed staff from 10:15-10:30 regarding the allegation. LPA checked the food supply of the facility from 10-10:15am. LPA observed there to be a sufficient amount of perishable food and non perishable food. LPA observed there to be a sufficient amount of fruits and vegetables. LPA interviewed residents regarding this allegation. Information from interviews revealed that food service is fine. Administrator had a telephone call with Licensing Program Manager (LPM) Cassandra Harris on 7/12/22 regarding issues the facility was having with R1 regarding food service. Based on the information obtained through interviews this allegation is deemed Unsubstantiated at this time.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME:
Cassandra Harris
TELEPHONE:
(818) 596-4342
LICENSING EVALUATOR NAME:
Wendell Smith
TELEPHONE:
(818) 738-4525
LICENSING EVALUATOR SIGNATURE:
DATE:
08/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
08/02/2022
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
31-AS-20220523171448
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY
COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office
,
21731 VENTURA BLVD., STE. 250
WOODLAND HILLS
,
CA
91364
FACILITY NAME:
COMPASSIONATE ELDERLY CARE MANAGEMENT SYSTEMS, INC
FACILITY NUMBER:
197608907
VISIT DATE:
08/02/2022
NARRATIVE
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32
Staff does not follow food menu for residents
It is alleged that the facility only has a good dinner menu but does not follow what is on the menu. LPA conducted interviews with residents and staff regarding this allegation. According to Title 22 regulations facility only has to have a sample menu and LPA was able to view the sample menu. Interviews with residents revealed that for the most part the menu is followed but it can change but the food is still of good quality. Based on the information obtained this allegation is deemed Unsubstantiated at this time.
Staff not meeting residents dietary needs
It is alleged that staff is not serving fruits or vegetables. LPA conducted interviews with residents and staff regarding this allegation. During the physical plant tour LPA checked the food supply and observed there to be a sufficient amount of fruits and vegetables. Based on the information obtained through interviews and observation this allegation is deemed Unsubstantiated at this time.
Exit Interview conducted. Copy of report issued.
SUPERVISOR'S NAME:
Cassandra Harris
TELEPHONE:
(818) 596-4342
LICENSING EVALUATOR NAME:
Wendell Smith
TELEPHONE:
(818) 738-4525
LICENSING EVALUATOR SIGNATURE:
DATE:
08/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as
explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE:
08/02/2022
LIC9099
(FAS) - (06/04)
Page:
2
of
2