197800131-6-23-2021-11-AS-MCAA-C4JNZS-20210702105447

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197800131
Report Date: 06/23/2021
Date Signed: 06/23/2021 03:31:39 PM

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
06/16/2021 and conducted by Evaluator Jade Jordan

COMPLAINT CONTROL NUMBER: 11-AS-20210616153908

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: 75	DATE:	06/23/2021
		UNANNOUNCED	TIME BEGAN:	09:29 AM
MET WITH:	Melanie Niez		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Facility staff did not safeguard resident's property

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jade Jordan conducted an unannounced visit to the facility. LPA met with Assistant administrator Melanie Niez. LPA explained the purposed of today’s complaint visit.

The investigation consisted of the following: Requested resident records (Face sheet, Personal Inventory, Physicians Report, Resident Roster) Requested Staff Roster, Interview 7 residents in care, and 3 staff including assistant admin.

Continued On 9099 C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Michael Cava	TELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Jade Jordan	TELEPHONE: (650) 388-2300
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2021

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-20210616153908

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: 06/23/2021

NARRATIVE

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Based on the Allegation: “Facility staff did not safeguard resident's property”

The investigation revealed of the following: R1 stated that personal belonging was thrown out during the rooms deep cleaning, and some things were found in the dumpster. R1 indicated that certain personal items specifically 2 prayer rugs, some watches and Dvd’s had gone missing. LPA reviewed R1’s Personal inventory list, and 2 rugs were specified on the inventory list. LPA interview Assistant Administrator who stated that no personal belongings were thrown away without any resident’s consent. Administrator stated that R1’s room was cleaned by staff to help prevent from becoming a fire hazard, and cluttering. R1 and R1’s roommates’ personal items were placed into large boxes and the residents were brought in to choose which items they would like to keep in their room, and what items they would like to be stored away. The Rugs were some of the items stored away. LPA asked to see stored items, including the rug of R1. Assistant Administrator said that the prayer rugs were put away within the facility by another staff and did not know where the boxes were being stored. LPA and Assistant Admin took a physical tour, to see if the boxes were being held in a specific vacant room. The items were last seen there. LPA did not observe any items in the vacant room.

Therefore; Based on LPA’s Record Review, Observation and Interviews conducted the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division,6 Chapter8 #, are being cited on the attached LIC 9099 D.”

An exit interview was conducted and a copy of this report, and appeal rights were provided

SUPERVISOR'S NAME: Michael Cava	TELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Jade Jordan	TELEPHONE: (650) 388-2300
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2021

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20210616153908

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
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/23/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/23/2021 Section Cited CCR 87217(b)	1 2 3 4 5 6 7	87217(b) Safeguards for Resident Cash, Personal Property, and Valuables. b) Every facility shall take appropriate measures to safeguard residents' cash resources, personal property and valuables which have been entrusted to the licensee or facility staff.	1 2 3 4 5 6 7	Facility will Replace/Return 2 Prayer rugs; and designate an area of locked storage for all personal belongings that will be held within the facility, with an inventory list. Send reciept to LPA of rugs and or photos if rugs are found, and a picture of where resident boxed stored items will be held by 07/09/21
	8 9 10 11 12 13 14	The licensee shall give the residents receipts for all such articles or cash resources. This standard was not met as evidenced by: LPA did not observe boxed personal belongings of residents personal items; placed by facility staff. This poses a potential Health,Safety,Personal rights risk to residents in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Michael Cava	TELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Jade Jordan	TELEPHONE: (650) 388-2300
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2021

LIC9099 (FAS) - (06/04)

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