197608908-12-17-2024-31-AS-EMIR-DD5V6W-20250121151012

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197608908
Report Date: 12/17/2024
Date Signed: 12/17/2024 02:55:08 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
06/30/2023 and conducted by Evaluator Michael Cava

COMPLAINT CONTROL NUMBER: 31-AS-20230630151824

FACILITY NAME:	MONTECEDRO		FACILITY NUMBER:	197608908
ADMINISTRATOR:	DAVID WEIDERT		FACILITY TYPE:	741
ADDRESS:	2212 EL MOLINO		TELEPHONE:	(626) 788-4900
CITY:	ALTADENA	STATE: CA	ZIP CODE:	91001
CAPACITY:	0	CENSUS: 203	DATE:	12/17/2024
		UNANNOUNCED	TIME BEGAN:	11:58 AM
MET WITH:	Ruzanna Sergeyev		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Facility food is of poor quality.
Facility does not meet ADA standards for residents in care.
Staff does not ensure bathroom is clean and sanitary.
Staff does not provide a comfortable temperature to residents.
Facility is malodorous causing breathing issues to residents.
Facility window screens are in disrepair.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Michael Cava conducted a subsequent complaint visit to the facility to conclude the investigation regarding the above allegations. The initial visit was made by LPA Cava on 07/03/23. In conjunction to that visit, LPA Cava conducted a Pre-Licensing visit to the facility for a change in ownership under facility #197610430. The LPAs Investigation consisted of interviews with staff and residents. A physical plant inspection was also made.

Facility food is of poor quality:
In regards to the allegation, it was reported that food is not served at standard quality. The Reporting Party (RP) provided no information of what types of food was not of standard quality, nor examples of food products were given by the RP. During the course of the investigation, LPA conducted interviews with ten (10) of ten residents. Interviews made with these residents do not corroborate with the allegation. Moreover, LPA conducted a physical plant inspection of the facility, which included observation of the kitchen, food

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

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 31-AS-20230630151824

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: MONTECEDRO	FACILITY NUMBER: 197608908
	VISIT DATE: 12/17/2024

NARRATIVE

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food supply, and food service. LPA did not observe food supply or service being inadequate. Based on interviews and a physical plant inspection, there was insufficient evidence that facility food is of poor quality. Therefore, the allegation is deemed Unsubstantiated at this time.

Facility does not meet ADA standards for residents in care:
In regards to the allegation, it was reported that the facility laundry vents are not clean, there are no grab bars in bathrooms, there is no trash access, there are not enough handicap parking spaces, and resident rooms do not have a senior safe tub. No additional information provided by the (RP). Moreover, no residents were identified to corroborate the allegation. LPA Cava conducted interviews with ten (10) of ten residents. Interviews made with these residents also do not corroborate with the allegation. In addition to resident interviews, a physical plant inspection was made, and LPA did not observe what was being reported. Based on interviews and a physical plant inspection, there was insufficient evidence to prove that the facility does not meet American Disability Accessibility (ADA) standards for residents in care. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff does not ensure bathroom is clean and sanitary:
In regards to the allegation, it was reported that rugs and facility smell of dead bodies. No additional information provided by the (RP). Moreover, no residents were identified to corroborate the allegation. LPA Cava conducted interviews with ten (10) of ten residents. Interviews made with these residents also do not corroborate with the allegation. Residents stated their rooms and bathrooms are cleaned regularly, and trash is thrown out every day. In addition to resident interviews, a physical plant inspection was made, and LPA did not observe or notice any unusual smell of what was being reported. Based on interviews and a physical plant inspection, there was insufficient evidence to prove that staff do not ensure the bathrooms are clean and sanitary. Therefore, the allegation is deemed Unsubstantiated at this time.

Staff does not provide a comfortable temperature for residents:
In regards to the allegation, it was reported that the facility has not been keeping the air conditioner on in the hallways. No additional information provided by the (RP). Moreover, no residents were identified to corroborate the allegation. Interviews made with (10) of ten residents do not corroborate with the allegation, expressing no concerns of the facility temperature not being comfortable. During the pre-licensing that was

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 31-AS-20230630151824

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: MONTECEDRO	FACILITY NUMBER: 197608908
	VISIT DATE: 12/17/2024

NARRATIVE

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held in conjunction with this complaint on 07/03/23, facility temperature appeared to be maintained at a comfortable level. During current visit, internal temperature still appears to be maintained comfortably. Furthermore, no resident concerns were made on this date regarding temperature being held at an uncomfortable level. Based on interviews and a physical plant inspection, it could not be proven that staff do not provide a comfortable temperature for residents. Therefore, the allegation is deemed Unsubstantiated at this time.

Facility is malodourous causing breathing issues to residents:
In regards to the allegation, it was reported that fumes and deodorizers have caused breathing issues. No additional information provided by the (RP). Moreover, no residents were identified to corroborate the allegation. Interviews made with (10) of ten residents do not corroborate with the allegation, expressing no concerns of the facility having an unpleasant smell. During the pre-licensing that was held in conjunction with this complaint on 07/03/23, and current complaint investigation held on this date, LPA did not observe or notice the facility having an unpleasant smell. Based on interviews and a physical plant inspection, it could not be proven that facility is malodourous causing breathing issues to residents. Therefore, the allegation is deemed Unsubstantiated at this time.

Facility window screens are in disrepair:
Regarding the above allegation, the RP did not identify where, or which windows, around the building, that was in disrepair. LPA Cava conducted a pre-licensing inspection in conjunction to the initial complaint investigation on 07/03/23. Another physical plant inspection was made on this day to insure the physical plant is compliant to regulation. Based on the physical plant inspection, LPA did not see any window screens in disrepair, or the physical plant being non-compliant at this time. Therefore, the above allegation is deemed Unsubstantiated.

This facility has since closed on July 31, 2023. A copy of this report will be forward to the last known address the Department has on file of the previous licensee.

SUPERVISOR'S NAME: Eva Miller	TELEPHONE: (818) 596-4373
LICENSING EVALUATOR NAME: Michael Cava	TELEPHONE: (818) 389-7921
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2024

LIC9099 (FAS) - (06/04)

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