197802917-10-20-2022-28-AS-MVAO-CKJRT6-20221025131747

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197802917
Report Date: 10/20/2022
Date Signed: 10/20/2022 02:32:50 PM

Unsubstantiated

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
07/13/2020 and conducted by Evaluator Angelica Rea

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20200713093346

FACILITY NAME:	RED ROSES VILLA		FACILITY NUMBER:	197802917
ADMINISTRATOR:	BRIAN BUENVIAJE		FACILITY TYPE:	740
ADDRESS:	13805 E. CREWE STREET		TELEPHONE:	(562) 941-3813
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90605
CAPACITY:	18	CENSUS: 11	DATE:	10/20/2022
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Brian Buenviaje		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff yells at resident's.
Facility is dirty.
Staff not providing laundry service to resident's.
Staff does not clean resident's room.
Resident's not receiving PRN medication as requested.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angelica Rea conducted another visit to deliver the final results of the investigation. On today's visit, LPA met with Administrator, Brian Buenviaje and Assistant Administrator, Gloria Gibson who assisted with today's visit.

The investigation consisted of interviews with Administrator, Staff #1, Resident #1- Resident #3, review of resident medications, and tour of facility.

Regarding the allegation that staff yell at residents. Administrator and Staff #1 denied the allegation. They stated that staff do not yell at residents. Residents interviewed were unable to corroborate the allegation. 3 out of 3 residents stated that staff do not yell at residents. Regarding the allegation that the facility is dirty and staff does not clean resident room(s), Staff interviewed stated that the facility is cleaned on a daily basis, and residents' room(s) are also cleaned daily. Residents interviewed were unable to corroborate the allegation. 3 out of 3 residents stated that the facility is cleaned daily, and their rooms are cleaned daily. LPA observed staff cleaning resident rooms and cleaning the facility during today's visit.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica Rea	TELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022

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 28-AS-20200713093346

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: RED ROSES VILLA	FACILITY NUMBER: 197802917
	VISIT DATE: 10/20/2022

NARRATIVE

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Regarding the allegation that staff is not providing laundry service to residents. Staff interviewed denied the allegation. Staff interviewed stated that staff are providing laundry service to residents. Staff interviewed stated that laundry is done 7 days per week, and some residents prefer to do their own laundry. Residents interviewed were unable to corroborate the allegation. 3 out of 3 residents stated that staff do provide them with laundry service. Regarding the allegation that residents are not receiving PRN medication as requested, staff interviewed denied the allegation. Staff stated that medication is given as prescribed, and PRN medication is administered as needed. LPA reviewed a sample of resident medication on today's visit and did not observe any deficiencies. Residents interviewed were unable to corroborate the allegation. 3 out of 3 residents stated that they have no problems with receiving their medication.

Based on LPA's observations and interviews, investigation revealed: 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.

No Deficiencies cited under California Code of Regulations Title 22. An exit Interview conducted and copy of report was provided to Ms. Gibson.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica Rea	TELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022

LIC9099 (FAS) - (06/04)

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