198201496-8-3-2020-11-AS-JHAD-BSFLWK-20200813090714

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198201496
Report Date: 08/03/2020
Date Signed: 08/03/2020 01:40:08 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
07/16/2020 and conducted by Evaluator Jose Calderon

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20200716103101

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:	08/03/2020
		UNANNOUNCED	TIME BEGAN:	09:49 AM
MET WITH:	Administrator Ella Laygas		TIME COMPLETED:	09:50 AM

ALLEGATION(S):

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Staff did not keep the facility free of bedbugs

INVESTIGATION FINDINGS:

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On 7/24/2020 at 01:00 PM, Licensing Program Analyst (LPA) Jose Calderon conducted a visit via face time in order to render investigation findings for the above allegation. Due to the situation surrounding the coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s complaint investigation findings was conducted telephonically via face time with Bella “Ella” Laygas , the facility administrator and the purpose of the visit was explained.

The investigation consisted of the following: On 7/240/2020 LPA conducted a video call and toured rooms 205, 207, 209, 211, 213, 215, 217, 219, 221 with the administrator. Checked for bed bugs on the beds none were found. On 7/24/2020, LPA conducted telephone interviews via face time with client R1-R10. On 7/27/2020 LPA interviewed Staff #'s S1-S6 to include maintenance man. LPA reviewed the following documentations on 7/26/2020, pest control report from Guarantee Pest Control dated 10/22/19, 11/11/19, 11/14/19 and Rhino Pest Control report dated 10/10/19. Rhino Pest Control reports confirms bed bugs on 10/10/19 and there is no mention of bed bugs on the other reports. No pest control reports found for 2020. Received and reviewed the facility floor plan, the resident and staff rosters.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Jose Calderon	TELEPHONE: (323) 213-1153
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2020

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-20200716103101

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: 08/03/2020

NARRATIVE

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The investigation revealed the following:

Regarding the allegation: Staff did not keep the facility free of bedbugs

On 7/24/2020 at 01:00 PM, LPA interviewed the facility Administrator Ella Laygas, regarding the above allegation, she confirmed that the facility had bed bugs in the past, but none in the month of July 2020. The residents have confirmed bed bugs in the facility in the past, but none for July and that the maintenance man would clean and spray the rooms. The most recent report dated 06/2020 indicated pest/insects in the facility, but no bed bugs for July.. On 7/24/2020 at 2:00 pm LPA interviewed R1-R10 all but R10 confirmed bed bugs in the past but none for July 2020. On 7/29/2020 LPA interviewed over the phone via face time Staff members #S1-S6 regarding the above allegation, six out of six staff stated they have seen bed bugs in the past, but none found for the month of July. They also confirmed pest control comes to the facility. Housekeeping clean residents’ room every day and deep cleaning once a week.

Based on interviews and record reviews conducted, there is insufficient evidence to support the allegation. We have found the complaint allegation unsubstantiated, although the allegation may have happened or is valid; there is not a preponderance of the evidence to prove that the alleged violation occurred.

A telephonic exit interview was conducted with Bella “Ella” Laygas, and a hard copy was provided via email for signature

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Jose Calderon	TELEPHONE: (323) 213-1153
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2020

LIC9099 (FAS) - (06/04)

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