198202967-10-17-2024-11-AS-JHAD-DABV7M-20241023161118

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198202967
Report Date: 10/16/2024
Date Signed: 10/17/2024 07:01:06 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/10/2024 and conducted by Evaluator Ernand Dabuet

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20241010104538

FACILITY NAME:	ANAND CARE CENTER III		FACILITY NUMBER:	198202967
ADMINISTRATOR:	MEHUL PATEL		FACILITY TYPE:	735
ADDRESS:	11143 SOUTH PRARIE AVE		TELEPHONE:	(310) 419-1225
CITY:	INGLEWOOD	STATE: CA	ZIP CODE:	90303
CAPACITY:	20	CENSUS: 14	DATE:	10/16/2024
		UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Meluh Patel		TIME COMPLETED:	04:26 PM

ALLEGATION(S):

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Staff do not provide comfortable accommodations for a client.
Client is being mistreated while in care and abused.
Staff do not ensure to meet a client's hygiene needs.

INVESTIGATION FINDINGS:

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On 10/16/24, the Department conducted an unannounced complaint visit at this facility. The Community Care Licensing (CCL) associate was greeted by Administrator Meluh Patel. CCL associate explained the purpose of this visit is to investigate the allegations mentioned above.

The investigation consisted of the following: A health and safety inspection. A copy of the Facility Staff Roster, Register of Facility Clients LIC 9020, service records for Client #1 that included: Admission Agreement LIC 604,Functional Capability Assessment LIC 9172,Identification and Emergency Information LIC 601,Preplacement Appraisal Information LIC 603, Appraisal/Needs and Services Plan LIC 625, Physician Report LIC 602, and Faciltiy House Rules/Personal Rights. A copy of City of Inglewood's Work Order Receipt.

(Evaluation Report continues LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024

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 11-AS-20241010104538

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: ANAND CARE CENTER III	FACILITY NUMBER: 198202967
	VISIT DATE: 10/16/2024

NARRATIVE

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INVESTIGATION REVEALED THE FOLLOWING:
Allegation: Staff do not provide comfortable accommodations for a client.
The details of this complaint alleged that staff did not provide comfortable accommodations to client #1 (C1). It is reported that (C1) is not provided comfortable accommodations and was without hot water for several days between 10/06/24 and 10/09/24 and (C1) is subjected to having to deal with mythical creatures as a resident at this facility.

On 10/16/24, between 9:30 am - 11:00 am, the Department interviewed (2) out of (2) administrator #1 (A1) and staff #1 (S1) who both verified that the facility did not have hot water. (A1) stated that the gas was shut off by both the City of Inglewood and Southern California Gas Company for leaking water pipes. The construction took effect from 10/01/24 through 10/02/24 a total of 48 hours. (A1 and S1) admitted that clients were all notified of no water availability through verbal communication with each client. According to (S1), all clients were notified that the gas had been shut off and were offered boiled water. (A1) stated that the gas pipe leaks and construction affected all commercial properties on South Prarie Avenue. (A1 and S1) denied that the facility had mythical creatures to prevent clients from having comfortable accommodations.

On 10/16/24, between 9:45 am - 11:50 am, the Department interviewed (9) out of (10) clients #2-#10 (C2-C10) all knew no hot water was available during construction. (C2-C10) confirmed staff had notified them that gas pipe leaks and construction would occur for a few days. (C2-C10) claimed they did not experience any inconvenience and realized it was not something the facility had control over. (C2-C10) verified that clients had options for boiled water for daily use while construction was in process. (C2-C10) could not corroborate that mythical creatures and found the facility to be a comfortable and safe environment.

On 10/16/24, between 11:54 am - 12:10 pm, the Department interviewed witness #1 (W1) Harbor UCLA Case Manager for client #1 (C1). (W1) stated the allegation is false. (WI) there have been similar erroneous associated with (C1) at other prior licensed care facilities that (C1) had resided in.

As a result of the Department review of the work service receipt from the City of Inglewood, it verified that construction did take place on 10/01/24 - 10/02/24. The Department inspected the activity and found the facility had hot water available. Based on the gathered information, the evidence does not support the allegation mentioned above. (Evaluation Report continues LIC 9099-C)

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20241010104538

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: ANAND CARE CENTER III	FACILITY NUMBER: 198202967
	VISIT DATE: 10/16/2024

NARRATIVE

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Allegation #2: Client is being mistreated while in care and abused.
The details of this complaint alleged that client #1 (C1) was subjected to mistreatment and abuse while in care at this facility. It has been reported that (C1) is harassed, discriminated against, and financially abused by staff and other clients. The report did not disclose further information, such as names, dates, and times of incidents.

On 10/16/24, between 9:30 am - 11:00 am, the Department interviewed (2) out of (2) administrator #1 (A1), and staff #1 (S1) denied this allegation. (A1) stated that (C1) has been a client at the facility since 05/07/24. (A1-S1) described (C1) enjoying being out in the community and exhibiting limited interactions with other staff or residents while at the facility. (A1-S1) claimed that incidents have not been brought to their attention to warrant a report. (A1) claimed that there have been no issues with (C1's) Personal and Incidental funds and receives funds monthly and verified through record logs.

On 10/16/24 between 9:45 am - 11:50 am, the Department interviewed (9) out of (10) clients #2-#10 (C2-C10) were unable to corroborate this claim. (C2-C10) are complimentary of staff and claim they have not experienced or observed any mistreatment, discrimination, harassment, or any type of abuse while a resident at this facility. (C2-C10) reported that they had no concerns with the health or safety of living at this facility.

On 10/16/24, between 11:54 am - 12:10 pm, the Department interviewed witness #1 (W1) Harbor UCLA Case Manager for client #1 (C1). (W1) reported this claim is untrue. This is the same type of allegation associated with (C1) at a prior licensed board and care and found no merit to the accusation.

As a result of the Department review of (C1's) Record of Client Safeguarded Cash Resources LIC 405 (dated: 05/30/24 - 10/01/24), it revealed that (C1) receives a monthly P&I of $177.00 and it is kept in order and accurate. The record indicated with a signature from (C1), a confirmation that funds were distributed and received by (C1). Based on the gathered information, the evidence does not support the allegation mentioned above.

(Evaluation Report continues LIC 9099-C)

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 11-AS-20241010104538

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: ANAND CARE CENTER III	FACILITY NUMBER: 198202967
	VISIT DATE: 10/16/2024

NARRATIVE

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Allegation #3: Staff do not ensure to meet a client's hygiene needs.
The details of the complaint alleged that staff does not ensure client # 1 (C1's) hygiene needs are met. It is reported that staff did not provide hygiene supplies to (C1) and that the facility did not have a bathtub available.

On 10/16/24, between 9:30 am - 11:00 am, the Department interviewed (2) out of (2) administrator #1 (A1) and staff #1 (S1) who denied this allegation. (A1 and S1) stated that the facility provided hygiene supplies to clients. (S1) stated part of the basic personal services is to provide hygiene care supplies. (A1) stated that (C1) has never requested supplies be replenished. (C1) knew when admitted that the facility did not have a bathtub and only showers were available in each unit.

On 10/16/24 between 9:45 am - 11:50 am, the Department interviewed (9) out of (10) clients #2-#10 (C2-C10) all were unable to support this claim. (C2-C10) claimed were aware that hygiene supplies were available and given when requested. (C7-C10) claimed they sometimes prefer to purchase their hygiene supplies as they have preferences.

On 10/16/24, between 11:54 am - 12:10 pm, the Department interviewed witness #1 (W1) Harbor UCLA Case Manager for client #1 (C1). (W1) stated this allegation is repetitive. The allegation is similar to claims connected with (C1) at prior licensed board and care facilities. (W1) stated there is no merit to any of these allegations mentioned in this complaint. (W1) was aware when admitted to this board and care, that the facility did not have a tub for bathing.

Client #1 (C1) was unavailable for an interview and unable to provide any information during the visit.

A result of the Department review of (C1's) Admission Agreement LIC 405 (dated: 05/18/24) outlines the basic personal services and hygiene supplies listed. Based on the gathered information, there is insufficient evidence to support the allegation mentioned above.

Based on the information gathered, an inspection of the facility, observation, and interviews conducted, an analysis of records reviewed, the Department found no evidence to support the allegations mentioned above. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations, did or did not occur, therefore the allegations are Unsubstantiated.

An exit interview was conducted with Maluh Patel, and copies of the reports were provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ernand Dabuet
LICENSING EVALUATOR SIGNATURE:	DATE: 10/16/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/16/2024

LIC9099 (FAS) - (06/04)

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