197802426-7-9-2021-28-AS-LHIS-C6VMT9-20210915095307

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197802426
Report Date: 07/09/2021
Date Signed: 07/09/2021 05:21:22 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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/08/2021 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20210108154128

FACILITY NAME:	BROOKDALE ALHAMBRA		FACILITY NUMBER:	197802426
ADMINISTRATOR:	WENTWORTH, NICOLE D		FACILITY TYPE:	740
ADDRESS:	1 E COMMONWEALTH AVE		TELEPHONE:	(626) 289-3871
CITY:	ALHAMBRA	STATE: CA	ZIP CODE:	91801
CAPACITY:	150	CENSUS: 70	DATE:	07/09/2021
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Tracey Holder, Administrator		TIME COMPLETED:	05:15 PM

ALLEGATION(S):

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1. Staff are not treating residents with dignity.
2. Administrator pressured a resident to change room.
3. Carpet in resident’s room smelled of urine.
4. Facility is not providing residents with transportation.
5. Staff are not reporting incidents to responsible parties.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent complaint investigation for the above allegations. LPA met with Administrator Tracey Holder and explained the purpose of the visit.
The investigation consisted of the following:

On 1/14/21, LPA Chan conducted the initial visit which consisted on a telephone interview with the Wellness Director and a video call to review the food supply and physical plant. 4 Residents were interviewed via Facetime on 4/12/21. On 5/11/21, LPA Chan held interviews with 4 Residents and 1 Staff at the facility. During today’s visit, LPA interviewed an additional 3 Staff.

The investigation revealed the following:
Allegation - Staff are not treating residents with dignity. Administrator and Staff have not heard any staff mistreating residents or without dignity. They stated the Staff treat the residents like family and are respectful.
(Continue on LIC9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021

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 28-AS-20210108154128

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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: BROOKDALE ALHAMBRA	FACILITY NUMBER: 197802426
	VISIT DATE: 07/09/2021

NARRATIVE

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7 out of the 8 residents stated that the staff are nice and helpful. They have not seen any staff being disrespectful to them.

Allegation - Administrator pressured a resident to change room. Administrator Holder denied ever pressuring a resident to change room. She stated residents may be asked to change their rooms to the lower floor due to their ambulatory status. Other times, residents request to change rooms themselves. Prior to a room switch, the Residents’ family or responsible party are contacted and in agreement before it is done. LPA interviewed one of the residents who recently had a room change and did not feel pressured by the Administrator.

Allegation - Carpet in resident’s room smelled of urine. According to interviews with Administrator and Staff, there are no rooms that have the urine smell on the carpet. If they come across a resident’s room with an odor, the caregivers or housekeepers will locate the smell and clean it up right away. LPA walked the facility and entered some residents’ rooms but did not notice any smell of urine. Residents interviewed also stated their rooms do not have any urine smell.

Allegation - Facility is not providing residents with transportation. The Administrator stated that residents can obtain transportation service if the request if given in advance. Residents are informed that transportation are provided usually on Monday, Wednesday, and Friday. The facility will also make exceptions if transportation is needed on Tuesday and Thursday. Residents who were interviewed did not have any issues with the transportation.

Allegation - Staff are not reporting incidents to responsible parties. Caregivers all stated that if there is an incident with the residents, they would inform the MedTech or nurse in charge right away. They document their notes and then the MedTech or Nurse will contact the resident’s responsible parties. LPA interviewed the MedTech who stated she or the nurse will contact the doctors, families, and/or responsible party to report any incidents that happen to the residents and will also document the contact made on their facility online computer system. In addition, the nurse will write the report to send to Community Care Licensing and Administrator will review them prior to sending out reports.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted. A copy of this report and appeal rights were given to the Administrator.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021

LIC9099 (FAS) - (06/04)

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