197802426-8-16-2021-28-AS-LHIS-C7AVE4-20210928162141

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197802426
Report Date: 08/16/2021
Date Signed: 08/16/2021 04:54:11 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
01/11/2021 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20210111171114

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: 63	DATE:	08/16/2021
		UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Tracey Holder, Executive Director		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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Staff are unable to communicate with residents effectively.
Facility is not observing changes in resident emotional condition.
Staff are not following up with residents about billing questions.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent visit for the allegatons listed above. LPA met with Tracey Holder, the Executive Director to explain the reason for the visit.

The investigaton consisted of the following:
On 1/14/21, LPA Chan conducted the initial investigation which consisted of a telephone interview with the Wellness Director and a video call. The LPA also requested copies of the Staff and Resident rosters including the contact information to be emailed to the LPA. LPA conducted a total of 7 Staff and 7 Residents.

The investigation revealed the following:
Regarding allegation - Staff are unable to communicate with residents effectively. According to the Administrator, the facility has staff who speaks Chinese in every shift. If there is no staff who can speak Chinese on that shift, a staff will utilize a translating device to communicate with residents or contact the family to assist with the translation.

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: 08/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2021

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-20210111171114

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: 08/16/2021

NARRATIVE

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Some staff stated they would ask another resident to help with translating if necessary, while some stated they are able to communicate with residents using hand gestures. LPA interviewed 7 residents and only 1 stated it is difficult to communicate with the staff since many of them do not speak Chinese. Others are able to speak a little English and communicate with staff. They stated there is always a staff who can speak the language to assist with their needs.

Regarding allegation - Facility is not observing changes in resident emotional condition. Based on interviews conducted with the Executive Director and staff, the caregivers and Med Techs observe for any changes in residents while doing their rounds. The changes are documented on their internal PCC log which consists of staff notes on each resident. The changes of condition are reported to family members and used to reassess a resident's level of care. LPA interviewed 3 caregivers who all stated they report changes to the nurse in charge for the day or the Med Tech and have been trained to look for signs of residents' behavior changes or changes of condition. Per Executive Director, the residents' personal service plan are updated every change of condition and/or up to 6 months.

Regarding allegation - Staff are not following up with residents about billing questions. Per Executive Director, if residents have any billing questions, they are referred to Jenna Moreno who is the Business Office Coordinator. The Business Office Coordinator will review the resident's file and inquire with the Corporate Office to obtain accurate information. Either the Executive Director or Business Office Coordinator will explain to the residents regarding any billing questions. LPA interviewed 7 residents and none of them had any issues about their billing.

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 with Tracey Holder. A copy of this report along with the appeal rights were provided.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2021

LIC9099 (FAS) - (06/04)

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