198204999-1-7-2025-11-AS-EMAZ-DF357H-20250323194218

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198204999
Report Date: 01/07/2025
Date Signed: 01/07/2025 03:23:15 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
01/02/2025 and conducted by Evaluator Deborah Lee

COMPLAINT CONTROL NUMBER: 11-AS-20250102152553

FACILITY NAME:	AMERICARE ASSISTED LIVING OF WESTCHESTER		FACILITY NUMBER:	198204999
ADMINISTRATOR:	PATRICK BAUTISTA		FACILITY TYPE:	740
ADDRESS:	8501 RAMSGATE AVENUE		TELEPHONE:	(310) 641-5808
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90045
CAPACITY:	6	CENSUS: 5	DATE:	01/07/2025
		UNANNOUNCED	TIME BEGAN:	08:53 AM
MET WITH:	Leia Dimalanta Joaquin		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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Facility staff do not offer engaging activities for residents

INVESTIGATION FINDINGS:

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On January 07, 2025 The Department of Social Services staff Deborah Lee conducted an unannounced complaint visit to the address the allegation listed above. Department staff was greeted by staff Cherry Valencia who granted access to the facility and the purpose of the visit was discussed. Subsequently, Administrator Leia Dimalanta Joaquin joined and assisted with visit.

The complaint alleges that the activities at the facility are not very engaging, and the residents mostly just watch TV.

The investigation consisted of the following: The department conducted tour of facility both inside and out, observatins made, the department reviewed and obtained copies of the following: Schedule of Activities,client roster, staff roster, Appraisal/Needs and Services plans for (R1-R5), Physicians reports for (R1-R5), Nursing notes for R1 (dated 10/10/24); interviews were conducted with 3 staff, Facility Administrator, LVN (W1), and Residents (attempts made for 3 of the 5 Residents)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 01/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2025

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-20250102152553

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: AMERICARE ASSISTED LIVING OF WESTCHESTER	FACILITY NUMBER: 198204999
	VISIT DATE: 01/07/2025

NARRATIVE

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Allegation: Facility staff do not offer engaging activities for residents

The department conducted an interview with Administrator (A1) who stated that the facility offers activities and have a schedule of activities; however due the R1-R5's physical and mental capability it is difficult to do activities other than taking them for walks when weather permits and watching their favorite program/movies on TV. A1 states that they make sure relaxing music is played throughout the facility. Additionally, A1 states that 3 of 5 residents prefer to be on phone playing games, reading news papers and/or watching TV. Lastly, A1 states that she would love to do more but it’s not feasible right now because of their physical and mental capacity and facility takes into account their preferences.

The department conducted interviews with Staff 1-Staff 3 (S1-S3), and asked the following questions: Do you have activities for the residents? What type of activities do you have? Do you the residents participate in the planned activities? Do you encourage participation? and Do the Residents express the type of activity they are interested in? 3 out of 3 staff stated that they do have activities for the resident but most of the residents are not alert or non-responsive and the ones who are responsive preferred to watch TV or stay in their rooms on phone or tablet. 3 out of 3 staff that they encourage residents to go on walks, go sit outside. 2 out of 3 staff state that they celebrate resident birthdays with parties and encourage participation.

The department conducted interview with Witness 1 (W1) who stated that due to 1 out of 5 resident's condition, it become uncomfortable for her to do activities, so she mostly stays in room and watch TV. Witness 1 says that she has observed staff engaging with this resident and having her come out of her room and sit at the table.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 01/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2025

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20250102152553

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: AMERICARE ASSISTED LIVING OF WESTCHESTER	FACILITY NUMBER: 198204999
	VISIT DATE: 01/07/2025

NARRATIVE

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The department conducted interviews with R2 and R3. 1 out of the 2 stated that they prefer to be in their room watching TV and/or being on the phone. 1 out of 2 stated they prefer reading as an activity. 2 out of 2 state that they are offered activities by the staff. Interview attempts were made for R1, R4, and R5 however due to their cognitive level they were unable to answer questions in a meaningful way. Additionally, there were not alert enough to answer the departments questions

The department reviewed and obtained the following documents: copy of Schedule of Activities which shows ample activities offered to the residents. resident roster, staff roster, Appraisal/Needs and Services plans for (R1-R5), outlining their functioning level, likes and dislikes, Physicians reports for (R1-R5), provided information on physical ability and diagnoses. Nursing notes (dated 10/10/24) for 1 of 5 residents requiring nursing services.

The department made the following observations: R1-R5 are between the ages of 78 and 98, all needing assistance with ambulating, they require the use of a walker or wheel chair. The department observed that R1-R5 were well groomed and their rooms were clean and sanitary, 2 of the 5 resident were siting in chairs in living room listening to music while nodding/napping. The department also noticed various board games on a table near the entrance of facility. During the visit, the department observed outside agency staff (LVN and Home health) tend to 2 of the 5 residents in the home.

Based on the information provided, observations made, interviews conducted, and analysis of service records, department staff found no evidence to support the allegation mentioned above.

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 UNSUBSTANTIATED.

No deficiencies were cited. Exit interview was conducted. A copy of this report was provided to the Administrator.

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SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Deborah Lee
LICENSING EVALUATOR SIGNATURE:	DATE: 01/07/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2025

LIC9099 (FAS) - (06/04)

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