198204972-2-16-2023-11-AS-MVAO-CQZPC9-20230418111133

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198204972
Report Date: 02/16/2023
Date Signed: 02/16/2023 02:38:37 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
02/09/2023 and conducted by Evaluator Martessa Brown

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20230209121859

FACILITY NAME:	ROSECRANS VILLA RESIDENTIAL CARE		FACILITY NUMBER:	198204972
ADMINISTRATOR:	SANDRA LOPEZ		FACILITY TYPE:	740
ADDRESS:	14110 CORDARY AVENUE		TELEPHONE:	(310) 675-9163
CITY:	HAWTHORNE	STATE: CA	ZIP CODE:	90250
CAPACITY:	135	CENSUS: 112	DATE:	02/16/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Sandra Lopez		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff did not safeguard resident's personal items
Staff did not keep objectionable laundry noises out of reach of resident areas

INVESTIGATION FINDINGS:

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On 2/16/23 Licensing Program Analyst (LPA) Martessa Brown conducted an initial complaint investigation regarding the above listed allegations. LPA called before entering and spoke with Administrator Sandra Lopez and facility is free from Covid-19. LPA explained the purpose of todays visit was to investigate the above allegations.

On 2/16/23, LPA toured the physical plant. LPA obtained and reviewed the following documents: Staff and client roster, house-rules, theft policy and cleaning schedule. LPA conducted interviews, Residents R1-R10, Administrator and Staff S2-S3.
The investigation revealed the following:

Regarding allegation #1: Staff did not safeguard resident's personal items

Next page.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Martessa Brown	TELEPHONE: (714) 743-4597
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023

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-20230209121859

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: ROSECRANS VILLA RESIDENTIAL CARE	FACILITY NUMBER: 198204972
	VISIT DATE: 02/16/2023

NARRATIVE

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It was alleged that staff does not safeguard belonging in the event resident is unable to defend property from being stolen or damage. On 2/16/23, LPA conducted interview with R1, stated when leaves the facility staff doesn’t lock the bedroom door and may leave open. R1 is afraid belongings will come up missing. During interviews with resident, 3 out of 10 stated they had belongings stolen. Also, 9 out of 10 residents stated staff will lock the doors and doesn’t leave room doors open and have no concerns. Interviews with Administrator and staff S2-S3 stated they lock the bedroom doors when leaving. All staff stated there has not been any reports of stolen items. LPA did not observe bedrooms open unless residents were in them or coming out. LPA reviewed Theft Policy procures. Based on interviews conducted and file reviews the above allegation unsubstantiated.

Regarding allegation #2: Staff did not keep objectionable laundry noises out of reach of resident areas.

It was alleged that facility laundry room makes loud noises in resident’s area. On 2/16/23, LPA conducted interview with R1, stated laundry room is very loud and is awaken out of sleep. During interviews with 9 residents, all stated they their laundry is picked up during the day and doesn’t have any concerns of laundry rooms noise at night or heard any complaints. Interview with Administrator and staff S2-3 stated housekeeping does laundry in the 2^nd room during the day and caregivers do laundry at night from 11pm-2AM. During interview Administrator had suggested to change R1 room to accommodate and refused. LPA observed 2 Laundry rooms and the 2^nd one was in use. R1 is located next to the 1 laundry room that was not being used. LPA observed residents cleaning schedule. Based on interviews conducted and file reviews the above allegation unsubstantiated.

Based on interviews conducted and records review, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted with Administrator, and a hard copy was provided

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Martessa Brown	TELEPHONE: (714) 743-4597
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023

LIC9099 (FAS) - (06/04)

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