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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198204399
Report Date: 12/16/2022
Date Signed: 03/23/2023 01:31:51 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 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
12/08/2022 and conducted by Evaluator Jose Calderon
COMPLAINT CONTROL NUMBER: 11-AS-20221208144308
FACILITY NAME:VILLA REDONDO CARE HOMEFACILITY NUMBER:
198204399
ADMINISTRATOR:MARIA BRAVOFACILITY TYPE:
740
ADDRESS:237 REDONDO AVENUETELEPHONE:
(562) 434-9931
CITY:LONG BEACHSTATE: CAZIP CODE:
90803
CAPACITY:80CENSUS: 56DATE:
12/16/2022
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:ADMIN DAVID HERNANDEZTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Staff are financially abusing resident
Facility staff are not preventing other residents from disturbing the
resident
Facility staff confiscated resident's mail
INVESTIGATION FINDINGS:
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This report serves as an amendment to clarify findings. It does not supersede the complaint investigation findings reflected on report created 12/16/2022

On 12/16/2022 Licensing Program Analyst (LPA) Jose Calderon conducted an unanno
unced visit to Villa Redondo Care Home. On 12/16/2022 at around 09:00 AM LPA Calderon and was greeted by Administrator (S1). LPA Calderon spoke to S1 prior to entering the facility to conduct a risk assessment. LPA Calderon explained the purpose of this visit is to deliver the findings pertaining to the above-mentioned allegation.



Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Eva M AlvarezTELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Jose CalderonTELEPHONE: (323) 213-1153
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022
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-20221208144308
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: VILLA REDONDO CARE HOME
FACILITY NUMBER: 198204399
VISIT DATE: 12/16/2022
NARRATIVE
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Licensing Program Analyst (LPA) Jose Calderon conducted an unannounced 10 day visit on 12/16/2022 approximately around 09:00 AM. LPA Calderon initiated an investigation for the above-mentioned allegation and conducted a face-to-face interview with Administrator (S1). On 12/16/2022 LPA Calderon interviewed W1 for complaint. On 12/16/2022 LPA Calderon requested copies of the following: Staff and Resident rosters, needs and service plan, physician report, incident reports for W1. On 12/16/2022 LPA Calderon interviewed R1-R5 for complaint. On 12/16/2022 LPA Calderon interviewed S1 – S4 for complaint.

Regarding Allegation #1: Staff are financially abusing resident. On 12/16/2022 LPA Calderon interviewed W1 who states that W1 debit card has been used by unknown person or person and W1 does not have any proof that staff members took W1 money. W1 states that that she can not prove that the administrator is using her debit card and she has asked her bank if money is being taken out of her account and the banks says no fraud has happened. On 12/16/2022 LPA Calderon interviewed S1-S4 who all state that no staff member would take, or any staff member would request money from W1. On 12/16/2022 LPA Calderon interviewed R1-R5 who all state that no staff has ever taken money or requested money from any resident and if this would have happened, they would report the incident to administrator. On 12/16/2022 LPA Calderon reviewed facility records and there is no proof provided by W1 that staff took or stole W1 money

Regarding Allegation #2: Facility Staff are not preventing other residents from disturbing the resident. On 12/16/2022 LPA Calderon interviewed W1 who states that R1 and R2 get drunk and yell always of the night and drop glass bottles on the ground making noise. W1 states that W1 has complained to staff and staff have not addressed the noise issues. On 12/16/2022 LPA Calderon and S1-S4 who all state that no staff member would if advised of any loud noise issue or any other resident being drunk would address the issue directly with the other resident in question. On 12/16/2022 LPA Calderon interviewed R1-R5 who all state that they live near W1 and have had no issues with drunk residents or residents making loud noises and if this would have happened, they would have reported the incident to staff. On 12/16/2022 LPA Calderon reviewed facility records and there is no incident report from W1 regarding 2 other residents being drunk or making loud noises at night.

SUPERVISOR'S NAME: Eva M AlvarezTELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Jose CalderonTELEPHONE: (323) 213-1153
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 11-AS-20221208144308
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: VILLA REDONDO CARE HOME
FACILITY NUMBER: 198204399
VISIT DATE: 12/16/2022
NARRATIVE
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Regarding Allegation #3: Facility staff confiscated residents mail. On 12/16/2022 LPA Calderon interviewed W1 who states that W1 mail specifically W1 phone bill and bank statement have stopped being mailed to W1, but W1 has no proof that facility staff has taken or refused to give W1 mail. W1 states that W1 mail has gone missing but W1 can not prove staff stole W1 mail. On 12/16/2022 LPA Calderon and S1-S4 who all state that no staff member would take or refuse to give mail to any resident. On 12/16/2022 LPA Calderon interviewed R1-R5 who all state that no staff has ever taken or refused to give them mail. R1-R5 state that they get all their mail and if the mail went missing residents would report the incident to administrator. On 12/16/2022 LPA Calderon reviewed facility records and there is no proof provided by W1 that staff took or refused to give W1 mail.

Based on interviews, observations, and supporting documentation, the preponderance of evidence standard has NOT been met; therefore, the allegation of “Staff are financially abusing resident” “Facility staff are not preventing other residents from disturbing the resident” “Facility staff confiscated residents mail” is found to be UNSUBSTANTIATED.

An exit interview was conducted and copy of the Complaint Report was provided to the Administrator (S1).

SUPERVISOR'S NAME: Eva M AlvarezTELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Jose CalderonTELEPHONE: (323) 213-1153
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3