197800131-7-12-2022-11-AS-EMAZ-CGS3KJ-20220728181914

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197800131
Report Date: 07/12/2022
Date Signed: 07/12/2022 03:59:51 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, 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
07/08/2022 and conducted by Evaluator Don Senaha

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20220708134824

FACILITY NAME:	CHATEAU LONG BEACH		FACILITY NUMBER:	197800131
ADMINISTRATOR:	BEATRICE ROMEO		FACILITY TYPE:	740
ADDRESS:	3100 E. ARTESIA BLVD.		TELEPHONE:	(562) 428-5371
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90805
CAPACITY:	184	CENSUS: 90	DATE:	07/12/2022
		UNANNOUNCED	TIME BEGAN:	09:34 AM
MET WITH:	Kristine Hartwell - Business Office Manager		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff moved resident out of room without resident's consent.

INVESTIGATION FINDINGS:

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On 07/12/2022 Licensing Program Analyst (LPA) Don Senaha initiated a complaint investigation for the allegation listed above. Today’s complaint investigation was conducted with Business Office Manager Kristine Hartwell.

The investigation consisted of the following: LPA requested and received resident roster, staff roster and other service documents on 07/12/2022. LPA interviewed staff (S1-S2), Residents (R1-R3) and Witness (W1-W2).

A plant inspection of the facility was conducted on 07/12/2022.
No deficiencies were found at the time of the visit.

Investigation revealed:

Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Don Senaha	TELEPHONE: (323) 629-5133
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2022

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 11-AS-20220708134824

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 DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: CHATEAU LONG BEACH	FACILITY NUMBER: 197800131
	VISIT DATE: 07/12/2022

NARRATIVE

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Allegation: Staff moved resident out of room without resident’s consent.

During the course of the investigation, LPA was unable to find any witnesses or documentation supporting the allegation above.

There is no evidence that supports staff moved resident out of room without resident’s consent. LPA interviewed resident (R1-R2), staff (S1-S2) and witness (W1) who stated resident (R1) has not moved out of his room. LPA spoke to staff (S1-S2) who stated the facility has never moved any resident out of their rooms without having a conversation prior to a move request. Staff (S1-S2) stated the facility has not forced residents to move out of their room unless for an emergency due to maintenance. Staff (S2) stated resident (R1) requested to move out of his room last month and resident (R1) has now retracted that statement and does not want to move out of his room. Resident (R2-R3) stated they have never heard of any residents being requested to move from their room by the facility.

LPA interviewed witness (W1) who stated resident (R1) has requested to move out of his room last month and the facility agreed to move resident (R1) from his room based on his request. Resident (R1) has decided not to move from his room. Witness (W1) stated this is not the first time resident (R1) has requested a move and then decided not to move from his room.

Resident (R2), staff (S2) and witness (W1) have no issues if resident (R1) stays in his current room.

Based on LPA’s interviews conducted and records reviews, the preponderance of evidence standard has not been met. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is Unsubstantiated

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Don Senaha	TELEPHONE: (323) 629-5133
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2022

LIC9099 (FAS) - (06/04)

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