197800131-11-14-2024-11-AS-JHAD-DBTQVP-20241210113041

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197800131
Report Date: 11/14/2024
Date Signed: 11/14/2024 02:49:32 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/06/2024 and conducted by Evaluator Lizeth Villegas

COMPLAINT CONTROL NUMBER: 11-AS-20241106121253

FACILITY NAME:	CHATEAU LONG BEACH		FACILITY NUMBER:	197800131
ADMINISTRATOR:	CINDY NICOLSONBOLONG		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:	11/14/2024
		UNANNOUNCED	TIME BEGAN:	09:18 AM
MET WITH:	Assistant Administrator Jennifer Rivas		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Facility staff are not providing resident with a reasonable amount of privacy while in their bedroom.

INVESTIGATION FINDINGS:

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On 11/14/24 at 9:18 a.m., Licensing Program Analyst (LPA) Villegas conducted an initial complaint visit regarding the allegation above. LPA met with Assistant Administrator Jennifer Rivas as the purpose of todays visit was explained.

The investigation consisted of the following: On 11/14/24 between 9:25am - 11am LPA conducted interviews residents # 1-9 (R1-R9), between 11am- 11:25am LPA conducted telephone interview with Administrator (A1), and between 11:25am- 12:20pm LPA conducted interviews with staff #1-3 (S1-S3). LPA obtain copies of documents pertinent to the complaint investigation for R1 and R2.

The investigation revealed the following:
Allegation- Facility staff are not providing resident with a reasonable amount of privacy while in their bedroom.
It is being alleged that people in the facility are coming into resident bedrooms without announcing themselves.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Lizeth Villegas	TELEPHONE: (818) 391-9974
LICENSING EVALUATOR SIGNATURE:	DATE: 11/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024

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-20241106121253

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: CHATEAU LONG BEACH	FACILITY NUMBER: 197800131
	VISIT DATE: 11/14/2024

NARRATIVE

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On 11/14/24 between 9:25am -11am LPA conducted interviews with R1-R9 regrading the allegation above, 8 of the 9 residents interviewed denied the allegation and reported that staff are knocking and announcing themselves before entering bedrooms. 8 of 9 residents interviewed reported having enough privacy at the facility. 1 of 9 residents interviewed reported staff will jiggle the door knob prior to opening the bedroom door and sometimes announce themselves after being asked who is entering the bedroom. 1 or 9 residents interviewed reported being unsure if they have enough privacy. On 11/14/24 between 11am- 11:25am LPA conducted telephone interview with A1 regarding the allegation above, A1 denied the allegation above and reported there are procedures in place for when entering a residents bedroom. Per A1, in-services on residents rights are held regularly to ensure privacy is being provided. On 11/14/24 between 11:25am- 12:20pm LPA conducted interviews with S1-S3 regarding the allegation above, 3 of 3 staff interviewed denied the allegation above and reported knocking, and announcing themselves before entering a residents bedroom. Per 3 of 3 staff interviewed, staff will enter a residents bedroom without consent if staff knocks on the bedroom door twice and there is no answer, this is done as a safety check.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Exit interview conducted with Assistant Administrator Jennifer Rivas, and a copy of this report was provided.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (424) 544-1027
LICENSING EVALUATOR NAME: Lizeth Villegas	TELEPHONE: (818) 391-9974
LICENSING EVALUATOR SIGNATURE:	DATE: 11/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2024

LIC9099 (FAS) - (06/04)

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