197803745-9-10-2024-28-AS-DSIS-D96RUA-20240916131936

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197803745
Report Date: 09/10/2024
Date Signed: 09/10/2024 03:40:23 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
07/11/2024 and conducted by Evaluator Tena Herrera

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240711103447

FACILITY NAME:	COUNTRY INN OF DOWNEY		FACILITY NUMBER:	197803745
ADMINISTRATOR:	ANA YESENIA GIRON		FACILITY TYPE:	740
ADDRESS:	11111 MYRTLE ST.		TELEPHONE:	(562) 869-2401
CITY:	DOWNEY	STATE: CA	ZIP CODE:	90241
CAPACITY:	150	CENSUS: 77	DATE:	09/10/2024
		UNANNOUNCED	TIME BEGAN:	12:16 PM
MET WITH:	Erika Becerra - Assistant Administrator/MedTech		TIME COMPLETED:	03:55 PM

ALLEGATION(S):

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Staff did not ensure air conditioner was working properly.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tena Herrera conducted an unannounced subsequent complaint visit to investigate the above allegation. LPA met with Erika Becerra and explained the purpose of today's visit. Shortly after Administrator Ana Giron arrived to assist with vist.

The investigation consisted of the following:
During initial visit on 7/15/24 LPA Alberto Lopez reviewed and obtained copy of staff and resident rosters.
During todays subsequent visit LPA Tena Herrera obtained staff and resident rosters, interviewed 3 Staff and 8 Residents, toured facility along side of Erika Becerra and reviewed thermostats throughout facility to ensure temperature was within regulation. LPA toured a total of 7 Resident rooms and toured kitchen where food supply was inspected and the walk-in refrigerator and freezer were inspected.

(Continued on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: David Sicairos	TELEPHONE: (323) 981-3982
LICENSING EVALUATOR NAME: Tena Herrera	TELEPHONE: 323-980-4633
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024

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-20240711103447

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: COUNTRY INN OF DOWNEY	FACILITY NUMBER: 197803745
	VISIT DATE: 09/10/2024

NARRATIVE

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The investigation revealed the following:
Allegation: Staff did not ensure air conditioner was working properly.
It is alleged that Resident #1's (R1) and several other residents air conditioners were not working, that it is very hot in R1's room, and that it is hotter in the dining area than it is outside. LPA toured a total of 7 resident rooms during todays inspection along with the common areas (dining, library, tv room) and all rooms had temperatures were within the required regulation, although the upstairs rooms did seem a bit warmer than downstairs, the thermostats read within the required regulation on facility temperature which is between 68-85 degrees. The rooms with the warmer temperature readings between 78-85 degrees were equipped with fans per the residents requests. Air conditioners on both floors seemed to be operable during visit and vents were giving cold/cool air. LPA toured the dining area and the thermostat within room read 82 degrees, there were fans that were operable and windows open, air conditioner was also observed to be blowing (at a low speed) cold air. Administrator confirmed that because of the recent heat wave they have the air-conditioning company do an early/additional service to ensure that all units are functioning properly and are scheduled to complete service tomorrow 9/11/24, air conditioning company visited facility on 9/9/24 to do pre-inspection for this service and stated that there is nothing broken and will be doing an early service on units 9/11/24. LPA interviewed 8 residents during todays visit and 7 out of 8 residents denied the above allegation and stated that it has not been hotter inside the facility compared to outside. Some residents stated it has been a little warmer than normal but it has not been intolerable, fans have been provided, cold water is being offered and hydration is being encouraged during these extreme heat conditions. All 8 residents interviewed also stated that they have not fallen ill do to being exposed to extreme heat conditions. LPA interviewed 4 staff and 4 out of 4 staff denied the above allegation and stated that the air conditioner has not been broken as of the past several months. Staff confirmed that there have not been any heat related illnesses and have been providing residents with accommodations such as ice cold water and fans during the most recent heat wave.

Based on statements and interviews conducted with staff and residents, tour of facility and resident rooms, there was not enough supportive evidence to concur with the reported allegation. 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. Exit interview held, and a copy of this report was provided to Administrator Ana Giron.

SUPERVISOR'S NAME: David Sicairos	TELEPHONE: (323) 981-3982
LICENSING EVALUATOR NAME: Tena Herrera	TELEPHONE: 323-980-4633
LICENSING EVALUATOR SIGNATURE:	DATE: 09/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024

LIC9099 (FAS) - (06/04)

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