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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198204758
Report Date: 08/09/2022
Date Signed: 08/09/2022 02:36:04 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
08/03/2022 and conducted by Evaluator Troy Agard
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20220803142332
FACILITY NAME:BROOKDALE OCEAN HOUSEFACILITY NUMBER:
198204758
ADMINISTRATOR:PARK, THOMASFACILITY TYPE:
740
ADDRESS:2107 OCEAN AVETELEPHONE:
(310) 399-3227
CITY:SANTA MONICASTATE: CAZIP CODE:
90405
CAPACITY:150CENSUS: 79DATE:
08/09/2022
UNANNOUNCEDTIME BEGAN:
10:18 AM
MET WITH:Joshua Castillo, Associate Executive Director TIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Facility elevator(s) are not maintained in operating condition.
INVESTIGATION FINDINGS:
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On 08/09/2022, Licensing Program Analyst (LPA) Troy Agard conducted an initial complaint investigation to address the allegation listed above. LPA Agard met with Joshua Castillo, Associate Executive Director and explained the purpose of this visit is to gather information for the complaint and deliver findings.

On 08/09/2022, the investigation consisted of the following: LPA Agard conducted a tour of the facility grounds. The facility is a 10-story high-rise apartment building located in a residential beach neighborhood. The facility is licensed for a capacity of 150. The facility consisted of the following: 116 apartment units/with bathrooms with 2 elevator shafts. LPA interviewed staff and residents, reviewed records, and delivered findings. LPA Agard requested the following documents: 1) A copy of the staff roster, 2) a copy of the resident roster with their date of birth, 3) Any elevator repair invoices or repair proposals.

On 08/09/2022, LPA delivered findings.
Cont on 9099c
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Ulysses CoronelTELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Troy AgardTELEPHONE: (323) 400-7109
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
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 4
Control Number 11-AS-20220803142332
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: BROOKDALE OCEAN HOUSE
FACILITY NUMBER: 198204758
VISIT DATE: 08/09/2022
NARRATIVE
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The investigation revealed the following: Regarding the allegation: Facility elevator(s) are not maintained in operating condition. “It’s being alleged there are one or two very old elevators in the building that break down often.” On 08/09/2022 LPA interviewed 8 out of a total of 79 residents. 8 out of 8 residents confirmed the allegation to be true. R2 states, “it’s been about 3 months. It’s dangerous. Many of us can’t make it down the stairs.” R5 states, “I’ve been here for 8 years. I’m on the third floor. The broken elevator has been down for at least 3 months. It’s frustrating.” R6 states, “Oh yeah, the elevator has been broken for months. I’m on the 7th floor. I have to wait awhile but I’m getting used to it. My main concern is if the second one breaks down. What will they do then?” R7 states, “this is an ongoing issue. This is not the first time these elevators have broken down. I think this might be the longest. Sometimes I can’t get to my room for almost 20 minutes because I live on the 10th floor.”

During interviews with staff, on 08/09/2022 LPA interviewed 5 out of a total of 54 staff. 5 out of 5 staff confirmed the allegation to be true. S1 states, “yes it’s been ongoing for 3 months now. There was an issue with the parts. Parts are taking some time to come in. We noticed some shaking with it, so we stopped it. If we ever had to evacuate, we wouldn’t use the elevator. We have evacuation chairs located on each stairwell (2), fire doors and the staff are trained in what to do.” S2 states, “yes, the elevator has been down since April. It hasn’t always been like this. It has never been down for this long.” S3 states, “yes, I have observed the elevator as not working. It has worked on and off a little in June and it went down again. The residents have brought up their concerns to us about it.” S5 states, “yes it has been broken for about two months. If we are doing trays it takes us longer to deliver. The residents will make comments that things are taking forever, or they had to wait for the elevator. So, we hear it one way or another.”

On 08/09/2022, LPA Agard reviewed the following records: A staff roster dated 06/28/2022: 5 of the staff interviewed match with the roster. A resident roster dated 08/09/2022: 9 of the residents interviewed match with the roster. An account history report from thyssenkrupp dated 08/09/2022. Under the “On Site Repair” section it shows the elevator underwent repair on 03/07/2022, 05/04/2022, 05/19/2022, 05/25/2022, 06/02/2022, 06/28/2022. Under the “Callback” section of the report it indicates the elevator has had several call backs for repairs on 03/18/2022, 03/30/2022, 05/02/2022, 05/17/2022, 06/04/2022, 06/23/2022. The report indicates both elevators had been down on 03/30/2020. On 10/02/2021, the elevator broke down with residents trapped inside. During walkthrough, LPA observed signage indicating 1 of 2 elevators as out of

Cont on 9099C

SUPERVISOR'S NAME: Ulysses CoronelTELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Troy AgardTELEPHONE: (323) 400-7109
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 11-AS-20220803142332
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: BROOKDALE OCEAN HOUSE
FACILITY NUMBER: 198204758
VISIT DATE: 08/09/2022
NARRATIVE
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service.

Based on LPA’s observation, interviews conducted, and record review, the preponderance of evidence standard has been met. Therefore, the above allegations are found to be substantiated. California Code of Regulations, Title 22, Division (6) and chapter (1) are being cited on the attached LIC 9099D.

An exit interview was conducted. Plans of corrections were developed. A copy of this report and appeal rights were given.

SUPERVISOR'S NAME: Ulysses CoronelTELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Troy AgardTELEPHONE: (323) 400-7109
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 11-AS-20220803142332
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: BROOKDALE OCEAN HOUSE
FACILITY NUMBER: 198204758
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/09/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/09/2022
Section Cited
CCR
87303(a)
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87303 Maintenance and Operation
a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
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Facility will have elevator(s) repaired by POC due date. Facility will develop a plan to address how they will ensure the residents’ personal rights are not violated due to their inability to access the elevator. POC must be sent to LPA via email or fax by POC due date.
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This requirement was not met as evidence by: Interviews conducted, record review and observation. All residents and staff unanimously confirmed the allegation to be true and the history of the issues. A review of service request shows frequent service calls due to the elevator malfunction. LPA observed elevator out of service.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Ulysses CoronelTELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Troy AgardTELEPHONE: (323) 400-7109
LICENSING EVALUATOR SIGNATURE:

DATE: 08/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4