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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198204758
Report Date: 10/03/2022
Date Signed: 10/03/2022 10:44:11 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
09/23/2022 and conducted by Evaluator Pamela Bunker
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20220923133915
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:
10/03/2022
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Joshua Castillo and Olga KirkseyacilityTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Facility did not safeguard resident's personal belongings.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint visit on Monday, October 03, 2022. Upon arrival at the facility. LPA Bunker called the facility via telephone and conducted a Risk Assessment. Based on the assessment, the facility is cleared of COVID-19 infection. LPA Bunker met with Associate Executive Director Joshua Castillo and Executive Director Olga Kirksey. LPA Bunker explained the purpose of today's visit.

The investigation consisted of the following: LPA Bunker interviewed staff 1-2 (S1-S2) and residents 1-8 (R1-R8). S1-S2 stated the facility staff safeguard residents’ personal belongings, property, and valuables. They were not aware of any residents missing any personal belongings until last week. Associate Executive Director Joshua Castillo stated that R1 mentioned her silver flatware sets were missing from her room over two (2) years ago during COVID-19. R2-R8 stated their personal belongings are safeguarded and not missing. See continued LIC9099-C page 2
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Stephanie CifuentesTELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Pamela BunkerTELEPHONE: (323) 213-1113
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2022
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 2
Control Number 11-AS-20220923133915
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: BROOKDALE OCEAN HOUSE
FACILITY NUMBER: 198204758
VISIT DATE: 10/03/2022
NARRATIVE
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Continued LIC9099-C page 2
Allegation: Facility did not safeguard resident's personal belongings
Staff 1-2 (S1-S2) stated the facility staff does safeguard residents’ personal belongings, property, and valuables. They were not aware of any residents missing any personal belongings until last week. R2-R8 stated their personal belongings are safeguarded. R1 stated she believes one of the caregivers took her sterling silver during COVID-19 over two (2) years ago. R1 stated she had no proof of who removed her personal belongings. Mr. Catillo and LPA Bunker observed R1's room and the corners of the room were stacked with boxes and bags. R1-R8 state staff is providing them with a comfortable environment. R2-R8 stated that they do not have any issues, problems, or concerns regarding any theft at the facility.

Investigation revealed the following: Interviews were conducted with staff 1-2 (S1-S2), and residents 2-8 (R2-R8), who stated staff safeguard resident's personal belongings. Associate Executive Director Joshua Castillo stated that R1 mentioned her silver flatware sets were missing from her room over two (2) years ago during COVID-19. Mr. Castillo stated he spoke to R1's daughter regarding the incident and she stated there was nothing missing from her mother's room. R1 stated she has a lot of boxes in her room, she is not organized, and it's hard to move from a big house to two (2) rooms. R1 stated she's not sure what happened to her sterling silver flatware, tea/coffee set with tray, and serving dishes. R1 stated the caregiver was helping her put the items away over two (2 ) years ago during COVID-19. R1 stated she reported her personal belongings missing to the facility staff and they did a search, but they were unable to find the box of sterling silver items. R1 stated the caregiver was still working during the search for her personal items that went missing. R1 stated she has no proof of who took the items. R1 stated she assumed the caregiver took her personal belongings since she was the person assisting her. R1 stated that the caregiver is no longer working at the facility. R1-R8 states they are happy at the facility, they love the ocean view and going for walks on the beach. R1-R8 stated staff is providing the necessary care and supervision to meet the resident's needs. Staff provided LPA Bunker with a copy of R1's personal property and valuables document and there was no description of any valuable sterling silver listed.
Based on interviews, available evidence, observation, information received, and records reviewed there was not enough sufficient evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is deemed unsubstantiated.
A copy of the Complaint Investigation Report LIC9099 and LIC9099-C was provided to the facility
There were no deficiencies cited. An exit interview was conducted.
SUPERVISOR'S NAME: Stephanie CifuentesTELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Pamela BunkerTELEPHONE: (323) 213-1113
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2