198320044-2-7-2023-11-AS-MVAO-CW3T8T-20230927143049

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320044
Report Date: 02/07/2023
Date Signed: 02/07/2023 05:22:03 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
08/22/2022 and conducted by Evaluator Jeremiah Randle

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20220822081650

FACILITY NAME:	ALTERNATIVE RESIDENTIAL CARE		FACILITY NUMBER:	198320044
ADMINISTRATOR:	MCNAMARA, MINDY		FACILITY TYPE:	740
ADDRESS:	2653 W 225TH STREET		TELEPHONE:	(310) 325-1735
CITY:	TORRANCE	STATE: CA	ZIP CODE:	90505
CAPACITY:	6	CENSUS: 6	DATE:	02/07/2023
		UNANNOUNCED	TIME BEGAN:	03:32 PM
MET WITH:	Minda Mc Namara Administrator		TIME COMPLETED:	05:03 PM

ALLEGATION(S):

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Facility staff physically abused residents resulting in bruising
Facility staff is using illegal drugs on the premises

INVESTIGATION FINDINGS:

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On 02/07/23, Licensing Program Analyst (LPA) Jeremiah Randle conducted a subsequent unannounced visit at this facility and was greeted by Facility Administrator, Minda McNamara (S1) . LPA explained the purpose of this visit is to deliver the findings on the allegation mentioned above.

The investigation consisted of the following: Licensing Program Analyst (LPA) Jeremiah Randle conducted a visit on 8/23/22 and 02/07/23. LPA reviewed copies of staff/resident rosters, SIR reports, physician's reports, appraisals/needs and services plans, and service records of Residents in care and other pertinent documents associated with this complaint.

The Department of Social Services investigator Dennis Douglas conducted a separate investigation that included an interview with clients, witnesses, and facility staff.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Jeremiah Randle	TELEPHONE: (323) 213-1116
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

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-20220822081650

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: ALTERNATIVE RESIDENTIAL CARE	FACILITY NUMBER: 198320044
	VISIT DATE: 02/07/2023

NARRATIVE

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On 08/22/22, the El Segundo Adult and Senior Care regional office (RO) received an “Anonymous.” complaint allegation that there is conduct inimical to the health and/or safety of clients in care. It is alleged facility staff is doing illegal drugs on the premises and while under the influence of the drugs the staff is abusing residents in care. It is alleged the abuse resulted in the residents sustaining bruises.

On 08/23/22, Licensing Program Analyst (LPA), Jeremiah Randle, conducted a 10-day visit to the Alternative

On 08/30/22, the El Segundo Adult and Senior Care regional office Investigations Branch (IB), I, Investigator, Dennis Douglas, conducted the interviews in reference to the allegations.

Investigation Revealed the Following

On 08/30/22, Investigator, Dennis Douglas, interviewed staff (S5).
During the visit, Investigator Dennis Douglas observed that staff members, S4, and S3, were present with
clients, C1-C6. Investigator Dennis Douglas was advised that Clients C1- C3 spoke little to no English. Clients C2 and C4, were sleeping at the time of my arrival. Client C5 and C6 were awake. Interviews were conducted with them during my visit. During the interview, I was informed that clients C1 and C3-C4 , are on hospice care while clients C2 and C5 are being treated by home health.

On 08/30/22, Investigator Dennis Douglas conducted a interview with facility client C6.
C6 has been a resident at the facility for approximately 4 months. There is no doctor at the facility. The facility is “okay.” The staff members are “pretty good.” S5 is polite and kind. S5 is married to another staff member there. She stated S4 is “nice.” S4 takes her outside in the front yard. S4 bathes her as well. C6 explained Contact S3 is the cook, but S3 also helps with the clients. S3 is also “nice” C6 explained it is very hard eating there. C6 is used to Mexican food and they sever mainly Filipino food. C6 has plastic teeth, so it is hard to eat anything tough.
C6 stated she has never observed any of the facility staff abusive to clients. C6 stated some of the clients are not corporative. Staff does not get out of line. Their job is hard.
C6 stated she feels safe there. C6 is not afraid of any of the staff members.

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Jeremiah Randle	TELEPHONE: (323) 213-1116
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20220822081650

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: ALTERNATIVE RESIDENTIAL CARE	FACILITY NUMBER: 198320044
	VISIT DATE: 02/07/2023

NARRATIVE

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On 08/30/22, Investigator, Dennis Douglas attempted to conduct an interview with facility client, C5. However, C5 was non-verbal.

On 08/30/22, Investigator, Dennis Douglas reviewed the files of each the facility clients. Investigator, Dennis Douglas obtained information of the hospice care and home health agencies for each of the clients C1-C6. Investigator, Dennis Douglas obtained copies of the “Identification and Emergency Information” forms in each of the facility clients/residents files.

On 08/30/22, Dennis Douglas conducted a interview with Facility Administrator, Minda McNamara (S1), who arrived at the facility shortly after I arrived. I explained the purpose of my contact.

McNamara (S1) denied that any of (S1) employees are abusive to the facility clients/residents. (S1) informed me there have been no prior allegations of physical abuse of the clients by facility staff. (S1) acknowledged the clients sometimes sustain bruising. However, (S1) explained that when it comes to elderly patients their skin is very fragile, and sometimes the medication they are taking can cause bruising. (S1) explained the clients also sustaining bruising by banging their own arms and legs on the furniture.
During my interview with (S1), (S1) advised me she was unaware of any of (S1) staff members using
illegal drugs.

On 10/17/22, Investigator Dennis Douglas conducted a interview with LVN Collateral Contact 2 (CC2) , who is the High Quality Home Health Care facility LVN for facility client, C5. LVN (CC2) advised LVN (CC2) was C5’s LVN off and on for approximately a year 3 times a week. LVN (CC2) advised LVN (CC2) had no concerns about abuse by facility staff members.

On 10/28/22, Investigator(s) Dennis Douglas and Investigator Lozano conducted a visit to the Alternative
Residential Care facility. During the visit, Investigator(s) Dennis Douglas and Investigator Lozano conducted an interview with facility staff member, S5. Investigator Lozano and I explained to S5 that we wanted to ask S5 several questions regarding the care of the facility clients/residents by facility staff.
S5 advised S5 has been working at the facility as a caregiver for approximately 2 years. S5 stated he has been in this field for approximately 7 years. S5 informed us S5 works the day shift (8 hours).

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Jeremiah Randle	TELEPHONE: (323) 213-1116
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20220822081650

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: ALTERNATIVE RESIDENTIAL CARE	FACILITY NUMBER: 198320044
	VISIT DATE: 02/07/2023

NARRATIVE

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During S5 interview he advised he had not witnessed any of the staff members physically abusing facility clients or causing injury. S5 denied abusing the clients himself.
S5 advised us none of the clients sustained any bruising. However, S5 recalled one client, “C5,” had sustained bruising on C5 wrist, S5 explained C5 sustained C5 injury after accidentally hitting C5 wrist on the table. During Investigator(s) Dennis Douglas and Investigator Lozano interview with S5, we asked if S5 witnessed or was aware of any of the other staff members using illegal drugs. S5 stated S5 had not. S5 denied using illegal drugs himself.

On 10/28/22, Investigator(s) Dennis Douglas and Investigator Lozano conducted a visit and interview with facility staff member, S4. Dennis Douglas and Investigator Lozano explained the purpose of our contact.
S4 informed Investigator Lozano and Dennis Douglas S4 will have been working at the facility as a caregiver for approximately 3 years on November 5^th of this year (2022). S4 advised us S4 has been working in the filed as a caregiver for approximately 10 years (since 2012).
During our interview with S4 we asked if she has ever witnessed any of the staff members physically abuse the clients at the facility. S4 informed Investigator(s) Dennis Douglas and Investigator Lozano S4 had not. Investigator(s) Dennis Douglas asked S4 if S4, herself, has physically abused any clients. S4 stated S4 had not. During interview with S4, Investigator(s) Dennis Douglas asked if she has observed bruising on any of the facility clients. S4 informed has not observed any bruising on the clients in a long time. S4 explained when S4 did observe bruising on the clients, it was primarily due to old age. During Investigator(s) Dennis Douglas and Investigator Lozano’s interview with S4, asked if S4 has suspected or “heard” any of the other staff members using or under the influence of illegal drugs on the premise. She informed us S4 had not. S4 denied using illegal drugs.

During the visit on 10/28/22, Investigator(s) Dennis Douglas and Investigator Lozano also conducted an interview with facility staff member/suspect, S3. Investigator(s) Dennis Douglas and Investigator Lozano explained the purpose of our contact S3 informed Investigator(s) Dennis Douglas and Investigator Lozano that he has been working at the Alternative Residential Care facility since June of this year (2022).
During interview with S3, he acknowledged observing a bruise on the arm of facility client/resident, C2. Investigator(s) Dennis Douglas and Investigator Lozano asked S3 how C2 sustained the bruise. S3 explained that C2 likes to lift things, sometimes causing C2 to injure C2. S3 also explained that when C2 transfers C2 to C2 wheelchair, C2 sometimes bumps C2 arm. S3 stated C2 family is notified whenever C2 sustains a significant injury. S3 stated they (C2 family) are okay with it. S3 acknowledged that no formal incident are generated documenting C2’s injuries. During Investigator(s) Dennis Douglas and Investigator Lozano interview with S3, S3 denied using any illegal drugs at the facility or physically abusing the facility clients/residents.

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Jeremiah Randle	TELEPHONE: (323) 213-1116
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC9099 (FAS) - (06/04)

Page: 4 of 6

Control Number 11-AS-20220822081650

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: ALTERNATIVE RESIDENTIAL CARE	FACILITY NUMBER: 198320044
	VISIT DATE: 02/07/2023

NARRATIVE

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Investigator(s) Dennis Douglas and Investigator Lozano asked S3 if S3 has ever used any illegal drugs in the past. S3 stated he had not. Investigator(s) Dennis Douglas and Investigator Lozano inspected the area and did not observe or detect any signs of illegal drugs on the premise.
On 12/09/22, Investigator(s) Dennis Douglas conducted a visit to one of S3 previous places of employment., Investigator(s) Dennis Douglas and Investigator Lozano made contact with, House Manager, Collateral Contact 3 (CC3). I explained to (CC3) that was there to ask him some questions regarding previous employee/suspect, S3. (CC3) confirmed that S3 was indeed a previous employee at the facility and that (CC3) worked with (CC3). (CC3) advised that S3 worked at the facility for approximately 5 years. I asked (CC3) why S3 no longer works at facility. (CC3) explained S3 sought a new job after S3 hours were decreasing. (CC3) advised that 3 of the six total clients currently at the facility were clients at the time S3 worked there. However, (CC3) advised that the 3 remaining clients were all non-verbal with Dementia. During my interview with Augustin, inquired about S3’s interaction with the clients during his time of employment. (CC3) stated he [S3] was “okay” with the clients. (CC3) advised me S3 treated the clients nicely. (CC3) stated there were no complaints of S3 regarding any mistreatment of clients at the facility. (CC3) described S3 as “a good person.” (CC3) was asked if there was ever suspicion of drug use with S3. (CC3) stated there was not. During interview with (CC3), CC3 was asked if he would hire S3 back. (CC3) informed, (CC3) would.

On 01/26/22, Investigator(s) Dennis Douglas attempt was made, via telephone, to contact C2 responsible party, received an automated voice mailbox, left a message requesting a call back. Investigators receive no return call from C2 responsible party.
On 01/26/22, Investigator(s) Dennis Douglas attempt to contact, via telephone, who is the responsible party of facility client, C5. However, I received an automated voice mailbox. I left a message requesting a call back. Investigators did not receive return call from C2 responsible party.

On 01/27/22, Investigator(s) Dennis Douglas attempted to contact, via telephone, Sean Hong, responsible party
facility client, C1. However, I received an automated voice mailbox. I left a message requesting a callback.
Investigators did not receive return call from .C1

On 01/27/23, Investigator(s) Dennis Douglas called that Embrace Healthcare agency and spoke with Director of Nursing, Collateral Contact 4 (CC4).. It was explained to Collateral Contact 4 (CC4) that our department was conducting an allegation into suspected physical abuse of clients at the Alternative Residential Care facility in the city of Torrance. Collateral Contact 4 (CC4) confirmed their agency provides care for facility client, C3.

Collateral Contact 4 (CC4) informed Investigator(s) Dennis Douglas their agency has never had any suspicion of abuse of the clients at Alternative Residential Care facility by facility staff.

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Jeremiah Randle	TELEPHONE: (323) 213-1116
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC9099 (FAS) - (06/04)

Page: 6 of 6

Control Number 11-AS-20220822081650

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: ALTERNATIVE RESIDENTIAL CARE	FACILITY NUMBER: 198320044
	VISIT DATE: 02/07/2023

NARRATIVE

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Oyson advised me “CC5” is the case manager/nurse for client, C3. CC4 advised CC4 would have CC5 give me a call.
On 01/27/22, Investigator(s) Dennis Douglas received a phone call from, CC5, who identified CC5 as a registered nurse from Embrace Healthcare. I explained to Nurse CC5 that our department was conducting an allegation into suspected physical abuse of clients at the Alternative Residential Care facility in the city of Torrance. Nurse CC5 confirmed that she is the nurse for facility client, C3. Nurse CC5 advised CC5 has been a nurse for C3 at the facility since her admission in May of 2022. CC5 advised that she has been a nurse for other clients at the Alternative Residential Care facility for approximately 3 years.
Nurse CC5 stated CC5 did not suspect any physical abuse of the clients by staff members at Alternative Residential Care, nor did she suspect any of the staff members of any other unethical behavior. Nurse CC5 advised CC5 currently visits the facility at least twice a month. However, there is another nurse who is there at least once a week and she also has never reported any aggressive or unethical behavior by the facility staff towards the clients in care.
Nurse CC5 stated the staff at Alternative Residential Care provide excellent care. CC5 stated CC5 believed that, if anything, the facility staff are “over-protective” of the clients.

Findings

In an investigation conducted by the Investigation Branch Department, interviewing staff, residents, and witnesses, reviewing incident report, and medical records, no evidence was found to support the allegation Conduct Inimical to the Health and/or Safety of Clients in Care, ( 1. Facility staff physically abused residents resulting in bruising. 2 Facility staff is using illegal drugs on the premises).

Based on information gathered, an inspection of the facility, observation, analysis of service records and other reports associated with this complaint, and interviews conducted, the Department found no evidence to support the allegation mentioned in this complaint.

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 during this visit.

An exit interview was conducted with Administrator, and a copy of the report was provided.

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Jeremiah Randle	TELEPHONE: (323) 213-1116
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC9099 (FAS) - (06/04)

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