197802917-10-11-2022-28-AS-RORN-CL2QJY-20221110111331

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197802917
Report Date: 10/11/2022
Date Signed: 10/11/2022 12:10:06 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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
10/03/2022 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20221003101750

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:	10/11/2022
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Brian Buenviaje		TIME COMPLETED:	12:10 PM

ALLEGATION(S):

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Facility has pests.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cynthia Chan conducted an unannounced complaint investigation for the allegation listed above. LPA met with Administrator Brian Buenviaje and explained the purpose of the visit.

The investigation consisted of the following:
LPA obtained copies of the staff roster, resident roster, and pest control reports from July 2022 through October 2022. Interviews were conducted with the Administrator, 3 Staff, 5 Residents, Program Social Worker, and the C & K Pest Control owner.

In regards to allegation - Facility has pests. It was alleged that a resident's leg swelled because of bed bugs. Per the Administrator, a resident reported seeing bed bugs in the room last week. However, they checked resident's room and none were observed. The Administrator provided a copy of their protocol when there are or suspect insects in a resident room. They are taking precautions to prevent any infestations of pests since residents like to bring in items from the community.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Tony Vasallo	TELEPHONE: (323) 981-3977
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022

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-20221003101750

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: RED ROSES VILLA	FACILITY NUMBER: 197802917
	VISIT DATE: 10/11/2022

NARRATIVE

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LPA interviewed 3 Staff who denied seeing any bed bugs or other insects. The pest control company comes once a month to inspect the facility and based on their reports, there were no indication of bed bugs on the premises. LPA interviewed a social worker who indicated one bed bug was observed 5 months ago but no more were found on the resident since that time. Interviews were held with 5 residents and 4 out of the 5 have not observed any bed bugs or other type of insects. One of the residents stated bed bugs were seen this morning. During the visit today, LPA inspected 6 rooms, which included the resident who reported seeing bed bugs this morning, and did not find any bed bugs or other pests at the facility.

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

An exit interview was held. A copy of this report along with appeal rights were provided to the Administrator.

SUPERVISOR'S NAME: Tony Vasallo	TELEPHONE: (323) 981-3977
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022

LIC9099 (FAS) - (06/04)

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