198320089-4-14-2023-11-AS-MVAO-CQZSBX-20230418134441

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320089
Report Date: 04/14/2023
Date Signed: 04/14/2023 02:06:33 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
02/15/2023 and conducted by Evaluator Ana Soto

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20230215162835

FACILITY NAME:	MERRILL GARDENS AT ROLLING HILLS ESTATES		FACILITY NUMBER:	198320089
ADMINISTRATOR:	DEBBIE INFIELD		FACILITY TYPE:	740
ADDRESS:	627 SILVER SPUR RD		TELEPHONE:	(310) 750-9877
CITY:	ROLLING HILLS	STATE: CA	ZIP CODE:	90274
CAPACITY:	150	CENSUS: 105	DATE:	04/14/2023
		UNANNOUNCED	TIME BEGAN:	12:40 PM
MET WITH:			TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff are not providing adequate food service.

INVESTIGATION FINDINGS:

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This amended report supersedes report dated 03/17/23. Licensing Program Analyst (LPA) Ana Soto conducted subsequent complaint visit to deliver amended findings and decisions for the allegation listed above. Today’s complaint investigation was conducted with Tracey Holder, Executive Director.

The investigation consisted of following: Interviews and Record reviews. On 02/23/23, LPA Soto interviewed S#1 - Operations Specialist. LPA toured the 2 kitchens (split kitchen), dining area, and inspected food (soups) and stove burners. LPA also requested copies of the following documents on 02/23/23: Resident Roster, Staff Roster, Menus (2 weeks), Staff trainings for S#2 - S#6, Invoice for repair/replace heat lamp. On 03/17/23, LPA interviewed S#2 - S#10, R#1 - R#10. Received invoice for repairs completed on Heat lamp.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ana Soto	TELEPHONE: (323) 383-8284
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2023

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-20230215162835

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: MERRILL GARDENS AT ROLLING HILLS ESTATES	FACILITY NUMBER: 198320089
	VISIT DATE: 04/14/2023

NARRATIVE

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Based on the LPA's investigation, the investigation revealed the following. For Allegation – Staff are not providing adequate food service. According to complaint the food is served cold to residents. Interviews conducted with S#1 - S#10, communicated that the food is not served cold. The food is warm and heated at the right temperature. Sometimes the residents get busy with other things and don't get to their food right away and it gets cold. There was a time when the hot plate was not working and the food was somewhat cold, but they got it fixed now. The staff reheats the food in the microwave if the residents still wanted to be hotter. Most of residents just like their food to be extremely hot, especially their soups, they like those to be steaming hot. Interviews conducted with R#1 - R#10, communicated that the food is always served cold. They would say about 90% of the time. The 3 meals a day are all cold. If the protein is not cold the vegetables are. If the vegetables aren't cold the meat is. Sometimes the staff gets it right and they get a hot meal, but hardly never. Some have complained to Management, but nothing has been done. It seems that instead of getting better it remains the same. LPA reviewed the repair invoice, and the heating lamp wasn't heating the food. The facility had the heating lamp repaired and they said it should fix the issue of cold food. LPA toured the kitchen and dining room; the food was at a good temperature. LPA observed the food in the pots and pans while they were cooking it. The food that was inside the pot and pans were boiling, and steam was rising from the pot and pans. The LPA did not taste the food. The interviews conducted and record reviewed do concur with the above allegation.

Based on LPA’s observations and interviews which were conducted and records review, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), LPA observed the following deficiency and issued a citation.

An exit interview was conducted with Tracey Holder, Executive Director, and a hard copy was of report and Appeal Rights were provided.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ana Soto	TELEPHONE: (323) 383-8284
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20230215162835

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: MERRILL GARDENS AT ROLLING HILLS ESTATES	FACILITY NUMBER: 198320089
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/14/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/14/2023 Section Cited CCR 87555(a)	1 2 3 4 5 6 7	87555(a) The total daily diet shall be of the quality and in the quantity necessary to meet the needs of the residents and shall meet the Recommended Dietary Allowances of the Food and Nutrition Board of the National Research Council....This was not met as evidence by:	1 2 3 4 5 6 7	Administrator already provided copy of proof for repair of Heat Lamp to LPA at the time of visit.
	8 9 10 11 12 13 14	Based on residents having been served cold food to eat for all 3 daily meals for the last few weeks.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ana Soto	TELEPHONE: (323) 383-8284
LICENSING EVALUATOR SIGNATURE:	DATE: 04/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2023

LIC9099 (FAS) - (06/04)

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