<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198202233
Report Date: 07/21/2022
Date Signed: 07/21/2022 05:12:46 PM

Substantiated


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
07/14/2022 and conducted by Evaluator Lourdes Montoya
COMPLAINT CONTROL NUMBER: 11-AS-20220714090135
FACILITY NAME:DENKER HOUSEFACILITY NUMBER:
198202233
ADMINISTRATOR:GREG SWIFTFACILITY TYPE:
735
ADDRESS:20902 DENKER AVENUETELEPHONE:
(310) 212-6721
CITY:TORRANCESTATE: CAZIP CODE:
90501
CAPACITY:9CENSUS: 9DATE:
07/21/2022
UNANNOUNCEDTIME BEGAN:
10:25 AM
MET WITH:Carla Kerker TIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is not being cleaned




INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
 On 7/21/2022, Licensing Program Analyst (LPA) Lourdes Montoya conducted an unannounced 10-day complaint visit at this facility. Upon arrival, LPA called the facility to conduct a risk assessment. LPA spoke with Facility Nurse Carla Kerker who confirmed the facility has a total of six (6) residents tested positive for Covid-19. LPA donned with full PPE and met with Facility Nurse Kerker. LPA explained the purpose of the visit.

The investigation consisted of the following: LPA toured the inside and outside grounds of the facility with Facility Nurse Kerker. LPA requested and obtained copies of Staff Roster, Resident Roster, and Food Menu. LPA interviewed two staff (S#1-#2) and eight clients (C#1-#8), while one client (C#9) was not present during the visit.

Report continued in LIC 9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Lourdes Montoya
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 11-AS-20220714090135
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: DENKER HOUSE
FACILITY NUMBER: 198202233
VISIT DATE: 07/21/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
investigations revealed:

Allegation: Facility is not being cleaned

It is alleged that facility is not being cleaned. The Reporting Party (RP) alleged the facility has failed to keep the home clean and sanitized. LPA toured the facility and checked the inside and outside grounds. Based on LPA’s observations, the carpet in the living room, hallways, the staircase are dirty, and the blinds in the living room and the emergency exit door on the second floor are not in good repair. LPA observed cigarette buds in the patio. Based on interviews with clients (C#1-#4, #7-#8) the carpet in their bedrooms are dirty. Clients (C#3-#4) revealed the blinds in their bedrooms are not in good repair. Clients (C#5 and #8) stated the blinds in their bedrooms are dusty. Staff (S#1) admitted the carpet is dirty. Staff #1 stated the licensee has a plan to replace the carpet with a wood floor. Based on observations and interviews, there is sufficient evidence to corroborate the allegation above.

Based on LPA observations and interviews, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated.

California Code of Regulations, Title 22, Division 6 and Chapter 8 are being cited on the attached LIC 9099D.

Exit interview was conducted with Facility Nurse Carla Kerker and a hard copy of the report and Appeal Rights were provided.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Lourdes Montoya
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 11-AS-20220714090135
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: DENKER HOUSE
FACILITY NUMBER: 198202233
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/15/2022
Section Cited
CCR
80087(a)
1
2
3
4
5
6
7
80087 Buildings and Grounds
(a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.
This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Facility Nurse Carla Kerker agreed to replace the carpet, clean and repair the blinds and clean the partio. Proof of correction shall be submitted to CCLD via email to lourdes.montoya@dss.ca.gov.
8
9
10
11
12
13
14
Based on LPA’s observations, the carpet in the living room, hallways, the staircase are dirty, and the blinds in the living room and the exit door on the second floor are not in good repair. LPA observed cigarette buds in the patio. Based on interviews with clients (C#1-#4, #7-#8) the carpet in their bedrooms are dirty. Clients (C#3-#4) revealed the blinds in their bedrooms are not in good repair. Clients (C#5 and #8) stated the blinds in their bedrooms are dusty. Staff (S#1-#2) admitted the carpet is dirty. Staff #1 stated the licensee has a plan to replace the carpet with a wood floor. This poses a potential risk to health, safety and/or personal rights risk to clients in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Lourdes Montoya
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3