197609105-8-19-2022-31-AS-NMAN-CHUN75-20220901101210

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609105
Report Date: 08/19/2022
Date Signed: 08/19/2022 01:13:30 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
11/22/2021 and conducted by Evaluator LaQueena Lacy

COMPLAINT CONTROL NUMBER: 31-AS-20211122140439

FACILITY NAME:	GRANDVIEW, THE		FACILITY NUMBER:	197609105
ADMINISTRATOR:	FLORES, YENI		FACILITY TYPE:	740
ADDRESS:	2211 W 6TH STREET		TELEPHONE:	(213) 380-7000
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90057
CAPACITY:	215	CENSUS: 159	DATE:	08/19/2022
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Yeni Flores		TIME COMPLETED:	11:49 AM

ALLEGATION(S):

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Facility staff member inappropriately sexually touched resident.
Facility staff member is impaired while caring for residents.
Facility staff member offered resident marijuana.

INVESTIGATION FINDINGS:

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An unannounced subsequent complaint visit was conducted on 8/19/2022 at 11:00am by Licensing Program Analyst (LPA) LaQueena Lacy. Upon arrival LPA met with Yeni Flores the administrator and explained the puropse of the visit. This investigation was conducted by Investigator Jose Santana with the Community Care Licensing Division’s (CCLD) Investigations Branch (IB).

#1 Facility staff member inappropriately sexually touched resident.

It was alleged that staff #1 (S1) came to bring R1 medication, and touch resident #1 (R1) on the breast, then started sucking it and pulled R1 close to feel S1’s erection.

During the investigation on 11/29/2021 interviews were conducted with residents, staff and other witnesses involved in R1’s care and supervision. Interviews at approximately 3:15pm with six (6) out of eight (8) staff on
Continued on LIC9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: LaQueena Lacy	TELEPHONE: (818) 661-0002
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022

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 31-AS-20211122140439

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: GRANDVIEW, THE	FACILITY NUMBER: 197609105
	VISIT DATE: 08/19/2022

NARRATIVE

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duty revealed that, the staff has limited interaction with S1 due to working different shifts/days and work duties. S1 works in the front office and dispense medication to residents in the office or delivers to residents room for those whom do not come to the office to receive their medications, also S1 is observed to be quite, nice and keeps to self and appears to eat lunch and take breaks in the car. During the investigation it was revealed that R1 had spoken to various witness and made inconsistent statements regarding the encounter with S1 and has made false allegations in the past. R1 was interviewed on 11/19/2021 and at a later date of 12/09/2021 by Investigator Santana at approximately 3:00pm regarding claims by R1 which was observed through video surveillance to be false. R1 had no explanation regarding the discrepancies. R1 asked Investigator Santana more than once whether the allegation could be used to avert an impending eviction for possessing, distributing, and consuming alcohol at the facility.
Based on interviews, observations, and record review, there is a not enough corroborating evidence to prove that the alleged violation occurred. Therefore, the allegation is UNSUBSTANTIATED at this time.

No deficiencies cited, Exit interview conducted. Copy of report, and appeal rights issued.

#2. Facility staff member is impaired while caring for residents.

It is alleged that Staff #1 (S1) is always high, smokes marijuana while at work in the car and had offered R1 marijuana. To investigation the above allegation, interviews were conducted with staff and residents on 11/23/2021 and 04/29/2022. Interviews conducted on 11/23/21 began at approximately 2:30pm and 04/29/2022 at 9:15am, with eleven (11) out of (12) residents have not witnessed staff under the influence of drugs or alcohol while on duty. During the investigation interviews with five (5) out of (5) staff confirmed that no staff have been witnessed to be under the influence of drugs or alcohol while on duty. Based on interviews, and observations, there is a not enough corroborating evidence to prove that the alleged violation occurred. Therefore, the allegation is UNSUBSTANTIATED at this time.

No deficiencies cited, Exit interview conducted. Copy of report, and appeal rights issued.

Continued on LIC9099C

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: LaQueena Lacy	TELEPHONE: (818) 661-0002
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022

LIC9099 (FAS) - (06/04)

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Control Number 31-AS-20211122140439

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: GRANDVIEW, THE	FACILITY NUMBER: 197609105
	VISIT DATE: 08/19/2022

NARRATIVE

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#3: Facility staff member offered resident marijuana.

It is alleged that Staff #1 (S1) offered Resident #1 (R1) marijuana. To investigate the above allegation, interviews were conducted revealed that ten (10) out of (12) residents have not heard or been told that staff offers drugs to residents. Five (5) out of (10) have not witnessed staff offering drugs to any residents. During the course of the investigation interviews with (5) out of (5) staff confirmed they have not witnessed any staff offering drugs to residents.

Based on interviews, and observations, there is a not enough corroborating evidence to prove that the alleged violation occurred. Therefore, the allegation is UNSUBSTANTIATED at this time.

No deficiencies cited, Exit interview conducted. Copy of report, and appeal rights issued

SUPERVISOR'S NAME: Naira Margaryan	TELEPHONE: (818) 596-4368
LICENSING EVALUATOR NAME: LaQueena Lacy	TELEPHONE: (818) 661-0002
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2022

LIC9099 (FAS) - (06/04)

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