198204399-6-12-2024-11-AS-SCIS-D6MQLJ-20240627121558

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198204399
Report Date: 06/12/2024
Date Signed: 06/12/2024 02:55:40 PM

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
06/05/2024 and conducted by Evaluator Elvira Gonzalez

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20240605132411

FACILITY NAME:	VILLA REDONDO CARE HOME		FACILITY NUMBER:	198204399
ADMINISTRATOR:	MARIA BRAVO		FACILITY TYPE:	740
ADDRESS:	237 REDONDO AVENUE		TELEPHONE:	(562) 434-9931
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90803
CAPACITY:	80; 80	CENSUS: 67	DATE:	06/12/2024
		UNANNOUNCED	TIME BEGAN:	10:13 AM
MET WITH:	Maria Bravo		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Facility staff are not properly addressing altercations between residents.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Elvira Gonzalez conducted an unannounced complaint visit to this facility to investigate the allegation mentioned above. LPA met with Leslie Estrada, Wellness Director, and explained the purpose of this visit. Administrator Maria Bravo joined LPA shortly after.

The investigation consisted of: Interviews conducted with Administrator, Maria Bravo, Facility Staff #1-#2 (S1-S2), Residents #1-#6 (R1-R6). LPA reviewed four client files and requested copies of the following records: Staff Roster, Resident Roster, R1-R4 Physicians Report, R1-R4 Individualized Service Plan, House Rules (page 16-18) of the Admissions Agreement, 30-Day Eviction Notice for R2, Unusual Incident Reports dated: 04/12/24, 04/18/24, and a copy of a written notice from resident.

Investigation revealed the following: Allegation: Facility staff are not properly addressing altercations between residents.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Elvira Gonzalez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 06/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024

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-20240605132411

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: VILLA REDONDO CARE HOME	FACILITY NUMBER: 198204399
	VISIT DATE: 06/12/2024

NARRATIVE

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The details of the complaint allege that the resident is being threatened both physically and verbally and the facility staff are not properly addressing altercations between residents.

Interviews conducted with 4 out of 6 residents revealed that staff are addressing altercations between residents. R1 stated that in the beginning staff would tell R1 to ignore R2 and avoid contact but is now noticing that the facility is more active in assisting R1 with altercations with R2. R1 stated that on one occasion, R2 purposely bumped into them as they were walking by, and facility staff immediately separated both R1 and R2. R1 stated that the facility has called the police on various occasions and are constantly redirecting both R1 and R2 to deescalate these altercations. R1 also stated that the facility has offered them to move to a different room in a different floor, but R1 stated that they are not ready to move just yet and said that they were going to wait another month to see if things got better, if they didn’t, then they will consider moving. Interviews conducted with 3 out 3 staff revealed that facility staff is actively addressing altercations between residents. LPA spoke with Administrator, Maria Bravo and she stated that she has have been working with both residents to try and avoid altercations between them. The facility has reached out to R2’s physician and has also offered R2 for a phycological evaluation but R2 continues to deny any help. Maria Bravo stated that R1 and R2 were once roommates, and as soon as the facility knew of these altercations, they immediately separated both residents into separate rooms. She stated that she has had several meetings with R2 and has tried talking with them to see how to resolve this issue, but it has not helped. Lastly, R2 was provided with a 30-Day Eviction Notice for violation of house rules.

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.

Exit interview held. A copy of the report was provided to Maria Bravo, Administrator.

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Elvira Gonzalez	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 06/12/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2024

LIC9099 (FAS) - (06/04)

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