198204079-3-28-2022-11-AS-AJKK-CDDUJQ-20220411153755

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198204079
Report Date: 03/22/2022
Date Signed: 03/28/2022 10:18:03 AM

Unsubstantiated

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
MONTERY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/14/2022 and conducted by Evaluator Lourdes Montoya

COMPLAINT CONTROL NUMBER: 11-AS-20220214125838

FACILITY NAME:	SPRING SENIOR ASSISTED LIVING		FACILITY NUMBER:	198204079
ADMINISTRATOR:	CRAIG WEECH		FACILITY TYPE:	740
ADDRESS:	20900 EARL STREET		TELEPHONE:	(310) 370-3594
CITY:	TORRANCE	STATE: CA	ZIP CODE:	90503
CAPACITY:	51	CENSUS: 33	DATE:	03/22/2022
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Craig Weech		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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COVID-19 visitation protocols are not being followed.
Residents are being denied visitation.

INVESTIGATION FINDINGS:

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On 3/22/2022, Licensing Program Analyst (LPA) Lourdes Montoya conducted a subsequent complaint visit at this facility regarding the allegations mentioned above. LPA Montoya called and conducted a risk assessment with Administrator Craig Weech. Shortly after, LPA met with Administrator Weech, who assisted with the visit. The purpose of the visit was explained.

The investigation consisted of the following:
On 2/17/2022, Licensing Program Analyst (LPA) Lourdes Montoya conducted an unannounced 10-day complaint visit. LPA Montoya conducted a tour of the facility; interviewed the administrator, one staff and a resident. LPA requested copies of the Staff roster (LIC 500), Resident roster (LIC 9020), screening log (January & February), Sign-in sheets (January and February); and Resident #1’s service records (Admission Agreement, Physician’s Report, and Appraisal) and other pertinent documents. LPA inquired questions relevant to the nature of the complaint.

Report continued in LIC 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Lourdes Montoya	TELEPHONE: (323) 981-4934
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022

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-20220214125838

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
MONTERY PARK, CA 91754

FACILITY NAME: SPRING SENIOR ASSISTED LIVING	FACILITY NUMBER: 198204079
	VISIT DATE: 03/22/2022

NARRATIVE

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On 3/8/2022, LPAs Lourdes Montoya and Antonia Alvizar made an unannounced subsequent complaint visit. Three (3) staff and five (5) residents were interviewed. Copies of screening/Sign-in/out logbook were obtained.

INVESTIGATION REVEALED:

Allegation: COVID-19 visitation protocols are not being followed.

It was alleged Covid-19 visitation protocols are not being followed by the facility staff. Reporting Party reported facility staff is not allowing family members to visit their loved ones in the facility unless they have a negative Covid-19 test regardless of vaccine status.

Based on the department’s record review, Provider Information Notice (PIN) Summary PIN 22-04-ASC, effective January 7, 2022 until February 7, 2022, states Licensees shall allow indoor visitation, including communal dining and in-room visitation, at all times and for all residents regardless of the vaccination status of the resident, if (1) the visitor is fully vaccinated, have had all recommended booster doses based on the table below and provide evidence of a negative COVID-19 test within one day of visitation for antigen tests, and within two days of visitation for Polymerase Chain Reaction (PCR) tests; OR (2) permit only outdoor visitation for those that do not meet all the aforementioned requirements in this section. Staff must screen visitors and the visitor must be asymptomatic.

Based on the department’s interview with the administrator (S1) and four staff (S2-S5), facility required visitors to present their vaccination card and a negative Covid-19 test (within 48 hours for PCR test or within 24 hours for rapid test) prior to entry during January and February 2022. The facility will provide a test kit and ask the visitor to take the test onsite for those who are willing to take the Covid-19 test. Visitors who are unvaccinated may be allowed for outdoor visitation if they can show documentation of a negative COVID-19 test taken within 48 hours (PCR) or 24 hours (rapid test). Interviews with five staff (S1-S5) and six Residents (R1-R6) revealed the facility screens visitor for Covid-19 symptoms prior to entry, temperature is checked, visitors are asked to use hand sanitizer or wash their hands in the designated bathroom sink near the main entrance door, visitors must sign in and out on the screening logbook; and wear a face covering. S2 revealed in an interview that on 2/7/2022, S2 assisted one visitor (W1) who attempted to enter the facility but refused to show proof of vaccination and a negative Covid test result. S2 stated W1 did not want to take a Covid-19 test onsite even after being informed that a free Covid-test kit is available. S2 stated W1 refused to comply to the indoor visitation protocols. Witness #1 was upset and left the facility. Based on observations, interviews and record reviews, there is no sufficient evidence to corroborate the allegation above.

Report continued in LIC 9099-C

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Lourdes Montoya	TELEPHONE: (323) 981-4934
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20220214125838

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
MONTERY PARK, CA 91754

FACILITY NAME: SPRING SENIOR ASSISTED LIVING	FACILITY NUMBER: 198204079
	VISIT DATE: 03/22/2022

NARRATIVE

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Allegation: Residents are being denied visitations.

It was alleged residents are being denied visitations. Reporting Party reported facility staff is not allowing outdoor visitation or visitation through the window onto the patio. Based on interviews with Staff (S1-S5) and Residents (R1-R6) no residents were denied outdoor visitations. S2 revealed in an interview that on 2/7/2022, S2 assisted one visitor (W1) who attempted to enter the facility but refused to show proof of vaccination and a negative Covid test result. S2 stated W1 voluntarily left the facility without going through the Covid-19 screening process and W1 did not ask for outdoor visitation. A review of the facility’s Screening forms from January 23, 2022 thru February 16, 2022, indicates no visitor was excluded from a visit. Based on observations, interviews, and record reviews, there is no sufficient evidence to corroborate the allegation above.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations, “COVID-19 visitation protocols are not being followed and Residents are being denied visitation” did or did not occur, therefore the allegations are unsubstantiated.

No deficiencies cited, exit Interview conducted, and report given to Administrator Craig Weech.

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Lourdes Montoya	TELEPHONE: (323) 981-4934
LICENSING EVALUATOR SIGNATURE:	DATE: 03/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022

LIC9099 (FAS) - (06/04)

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