198201496-6-9-2020-11-AS-JHAD-BQQUQ4-20200619154632

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198201496
Report Date: 06/09/2020
Date Signed: 06/09/2020 04:43:14 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 DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/01/2020 and conducted by Evaluator Martessa Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20200501173643

FACILITY NAME:	BEVERLY HILLS GARDENS CARE CENTER		FACILITY NUMBER:	198201496
ADMINISTRATOR:	JOHN STIENFIELD		FACILITY TYPE:	740
ADDRESS:	1470 S. ROBERTSON BLVD		TELEPHONE:	(310) 273-3668
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90035
CAPACITY:	110	CENSUS: 83	DATE:	06/09/2020
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Bella Naygus, Administator		TIME COMPLETED:	12:15 PM

ALLEGATION(S):

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Facility staff yell at residents.
Residents' hygiene needs are not being met.

INVESTIGATION FINDINGS:

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On 6/9/20 at 10:00 AM, Licensing Program Analyst (LPA) Martessa Brown conducted a subsequent visit in order to render investigation findings for the above allegations. Due to the situation surrounding the coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s complaint investigation findings was conducted telephonically with Bella Naygas, the facility administrator and the purpose of the visit was explained.

The investigation consisted of the following: On 5/8/2020 at 11:30 am, Licensing Program Analyst (LPA) Martessa Brown met with staff Yvumi Tomsin. During the visit LPA toured the physical plant 1st and 2nd floors, 2 TV rooms, dining area, kitchen, and 2 bathrooms. LPA conducted telephone interviews between 11:40 AM-12:40 PM with caregivers and administrator. LPA requested copies from the administrator of the following records of Residents (R1) and (R 2) most recent physician reports, individual's needs and service plan, client and staff roster’s, admission policy’s agreement, employee training documents and house rules, all documents to be emailed to LPA. On 6/5/20 LPA interviewed Residents, R3-R8 regarding the allegations.
LIC9099-C is on the next page.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Martessa Brown	TELEPHONE: (714) 743-4597
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2020

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 11-AS-20200501173643

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 DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BEVERLY HILLS GARDENS CARE CENTER	FACILITY NUMBER: 198201496
	VISIT DATE: 06/09/2020

NARRATIVE

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The investigation revealed the following:

LPA reviewed the following documents for the above complaints, admissions agreement and house rules revealed the facility provides assistance to residents daily needs such as grooming, bathing, eating etc. Staff & client rosters, in service staff training schedules, residents R1 and R2 Appraisal Needs and Service Plan.

Regarding the allegation: Facility staff yell at residents.

On 05/8/20 and 6/5/20, LPA interviewed the Administrator Bella Naygas and assistant Clifford Johns over the telephone regarding the above allegations. They both indicated they have not witnessed any staff members yelling at the residents. There is a resident that has a hearing impairment and staff must speak louder for the resident to hear them. Administrator stated R1 did not have his hearing aid due to losing it at the hospital. The Administrator stated they had reached out to his hearing doctor to obtain a new hearing aid but due to COVLD-19 Pandemic they were unable to schedule an appointment. On 05/8/20 and 6/5/20 LPA interviewed staff members (S1-S4) regarding the above allegation, staff have stated they do not yell at any residents nor have they witnessed other staff members yelling. Staff stated they may have to speak louder to residents that are hard of hearing but doesn’t yell at them. LPA interviewed Residents R3-R7 regarding the above allegation and all residents stated that staff members have not yelled at them and they have not witnessed any residents being yelled at by staff. LPA was unable interview R1-R2; R1 is currently in the hospital; R2 no longer resides at the facility and the Administrator was not aware where R2 moved.

LIC9099-C is on the next page.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Martessa Brown	TELEPHONE: (714) 743-4597
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2020

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20200501173643

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 DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BEVERLY HILLS GARDENS CARE CENTER	FACILITY NUMBER: 198201496
	VISIT DATE: 06/09/2020

NARRATIVE

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Residents' hygiene needs are not being met.

On 5/8/20 and 6/5/20, LPA interviewed the Administrator Bella Naygas and Assistant Clifford Johnson over the telephone regarding the above allegation. They stated staff has not refuse to assist residents while in care. Also, staff provide all services to residents that may need assistants with daily living. They have no concerns with staff not meeting residents needs. LPA interviewed residents over the telephone on 6/5/20, (R3-R7) and they all have stated they have no problems with staff assisting them nor aware of any residents not being assisted by staff. All interviewed residents stated they are self-sufficient. Staff members were interviewed over the telephone on 5/8/20 and 06/05/20, staff members (S1-S4) stated they assist all residents if they need assistance with hygiene or showering? LPA was unable interview R1-R2; R1 is currently in the hospital; R2 no longer resides at the facility and the Administrator was not aware where R2 moved.

Based on interviews and documentation during the investigation Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated or unfounded

A telephonic exit interview was conducted with Administrator, and hard copy was provided via email for records

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Martessa Brown	TELEPHONE: (714) 743-4597
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2020

LIC9099 (FAS) - (06/04)

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