197800131-11-22-2022-11-AS-MVAO-CMATDD-20221220133811

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197800131
Report Date: 11/22/2022
Date Signed: 11/22/2022 02:32:20 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 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
11/17/2022 and conducted by Evaluator Ernand Dabuet

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20221117134452

FACILITY NAME:	CHATEAU LONG BEACH		FACILITY NUMBER:	197800131
ADMINISTRATOR:	KHATERA BAHADORY		FACILITY TYPE:	740
ADDRESS:	3100 E. ARTESIA BLVD.		TELEPHONE:	(562) 428-5371
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90805
CAPACITY:	184	CENSUS: 86	DATE:	11/22/2022
		UNANNOUNCED	TIME BEGAN:	09:03 AM
MET WITH:	Kristine Hartwell		TIME COMPLETED:	02:47 PM

ALLEGATION(S):

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Licensee did not ensure hot water is available to residents.
Facility staff did not ensure hot water is between 105 and 120 degrees for resident use.

INVESTIGATION FINDINGS:

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On 11/22/22, Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced visit to the facility and was greeted by Business Manger Kristine Hartwell staff #1 (S1). LPA explained the purpose of this visit is to investigate the allegations mentioned above.

The investigation consisted of the following: LPA initiated an investigation for the above-mentioned allegations. Interviews with staff #1-#2 (S1-S2), residents #1-#2 (R1-R2). LPA requested copies of the following: staff and resident rosters, and other pertinent records in association with this complaint.

Evaluation Report continues LIC 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ernand Dabuet	TELEPHONE: (323) 629-5526
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022

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-20221117134452

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: CHATEAU LONG BEACH	FACILITY NUMBER: 197800131
	VISIT DATE: 11/22/2022

NARRATIVE

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INVESTIGATION REVEALED THE FOLLOWING:

Allegation: Licensee did not ensure hot water is available to residents.
Facility staff did not ensure hot water is between 105 and 120 degrees for resident use.

The details of the complaint stated the facility did not have hot water for three weeks. The complainant reported that resident #1 (R1) only had lukewarm water even when water heaters were fixed after 11/14/22, and still did not produce hot water. The Department reached out to the complainant and was not able to obtain additional information.

The Department interviewed staff #1 (S1) who admitted there have been some issues with the facility water heater and water temperature. (S1) stated on 10/31/22 a “Notice to All Residents” was posted throughout the facility to inform residents of ongoing repairs with the water heaters are being serviced by the maintenance staff in lieu of a work order made by resident #2 (R2). On 11/09/22 the facility contracted M.R.S. Plumbing Inc. to replace two (2) defective 100-gallon water heaters with four (4) new Navien (NPE-240a2) tankless water heaters. According to maintenance staff supervisor staff #2 (S2), the service took a few days to repair/replace the water heaters from 11/09/22 through 11/17/22. During that period, the water heaters were replaced in stages taking one defective heater and replaced with two new tankless heaters. (S2) stated it was the same process until the work was completed on 11/17/22. On 11/13/22, (R2) placed another work order requesting to have the water temperature inspected as there is no hot water even after the new water heaters were installed. Despite installing new tankless water heaters and replacing defective heaters, (S1-S2) reported that the issue of no hot water persisted. The facility did not have a backup plan for resolving the recurring problem.

The Department inspected the following rooms for water temperature: #206 (88.6) F; #207 (87.1) F; #205 (88.0) F; #208 (123.4) F: #202 (87.3) F; #209 (121.9) F; #108 (119.6) F; #107 (117.9) F; #109 (117.1) F; #110 (90.7.) F; and #114 (90.1) F. Eight of the eleven were found to be out of compliance with Title 22. For residents, hot water temperatures were not between 105 and 120-degrees Fahrenheit. A comment could not be obtained from resident #1 (R1).

Evaluation Report continues LIC 9099-C

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ernand Dabuet	TELEPHONE: (323) 629-5526
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20221117134452

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: CHATEAU LONG BEACH	FACILITY NUMBER: 197800131
	VISIT DATE: 11/22/2022

NARRATIVE

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Based on the information gathered, an inspection of the facility, observation, analysis of documents reviewed, and interviews conducted, the Department found sufficient evidence to support the allegations mentioned in this complaint.

Based on the Department's observation, interviews, records reviewed, and analysis, the preponderance of evidence standard has been met, therefore the allegation of “Licensee did not ensure hot water is available to residents" and "Facility staff did not ensure hot water is between 105 and 120 degrees for resident use" are found to be: Substantiated. California Code of Regulations, Title 22, Division 6, Chapter 8, is cited on the attached LIC 9099-D.

An exit interview with Kristin Hartwell and a copy of report and appeal rights were provided.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ernand Dabuet	TELEPHONE: (323) 629-5526
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022

LIC9099 (FAS) - (06/04)

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Citations on this Visit Report are Under Appeal!

Control Number 11-AS-20221117134452

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: CHATEAU LONG BEACH	FACILITY NUMBER: 197800131
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/22/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Under Appeal Type A 11/23/2022 Section Cited CCR 87303(e)(2)	1 2 3 4 5 6 7	87303 Maintenance and Operation (e) Water supplies and plumbing fixtures shall be maintained.. (2) Faucets used by residents for personal care... shall deliver hot water. Hot water temperature controls shall be maintained... regulate...105-degree F (41 degrees C) and not more than 120 degree F (49 degrees C).	1 2 3 4 5 6 7	Licensee will adhere to Title 22 Section 87303 and ensure that water temperature is maintained to regulate hot water not less than 105 degrees F and not more than 120 degrees F. The licensee will make adjustment with the water heaters. Proof of correction is due by: 11/23/22 faxed 323-981-1781.
	8 9 10 11 12 13 14	This requirement is not met as evidenced by: During the inspection, LPA found 8 of the 11 rooms were not compliance with Title 22. hot water temperatures were not between 105- and 120-degrees F. This volation poses an immediate health and safety to residents in care.	8 9 10 11 12 13 14
Under Appeal Type A 11/22/2022 Section Cited CCR 87307(a)(2)	1 2 3 4 5 6 7	87307 Personal Accommodations and Services (a) Living accommodations and grounds shall be related to the facility's function. The facility shall... provide comfortable living accommodations..(2) The premises shall be maintained in a state of good repair and shall provide a safe and healthful environment.	1 2 3 4 5 6 7	Licensee will adhere to Title 22 Section 87307 and ensure the faclity in in good repair and hot water is available at all times.The licensee will replace any defected water heaters. Proof of correction is due by: 11/23/22 faxed 323-981-1781.
	8 9 10 11 12 13 14	This requirement is not met as evidenced by: During the inspection and interviews the facility failed to provide a safe and healthful environment for not having hot water temperature from 11/09/22 - 11/17/22. This volation poses an immediate health and safety to residents in care.	8 9 10 11 12 13 14	This violation is corrected during the visit. An invoice from MRS Plumbing Inc was provided for servcies.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ernand Dabuet	TELEPHONE: (323) 629-5526
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2022

LIC9099 (FAS) - (06/04)

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