198320301-8-9-2024-11-AS-UCOL-D86P5T-20240815110112

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320301
Report Date: 08/09/2024
Date Signed: 08/09/2024 03:44:31 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, 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
08/28/2023 and conducted by Evaluator Regina Cloyd

COMPLAINT CONTROL NUMBER: 11-AS-20230828142032

FACILITY NAME:	BENTLEY MANOR		FACILITY NUMBER:	198320301
ADMINISTRATOR:	ALCARAZ, MONA M		FACILITY TYPE:	740
ADDRESS:	3425 MCLAUGHLIN AVENUE		TELEPHONE:	(213) 478-0460
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90066
CAPACITY:	27	CENSUS: 24	DATE:	08/09/2024
		UNANNOUNCED	TIME BEGAN:	08:56 AM
MET WITH:	Administrator Mona Alcaraz		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff do not ensure that resident's incontinence needs are met.
Staff do not maintain facility clean and sanitary at all times.
Staff are not addressing rodent problem.

INVESTIGATION FINDINGS:

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On 08/09/2024 Licensing Program Analyst (LPA) Regina Cloyd conducted a subsequent complaint investigation at the above facility to address the following allegation(s). LPA met with Administrator Mona Alcaraz and explained the purpose of the visit. The investigation consisted of the following: During today’s investigation, LPA toured the facility, observed mealtime, and interviewed 10 residents and four (4) staff members which included the Administrator, Cook/Caregiver, and two (2) Caregivers. On 09/07/23, Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint visit on and met with Assistant Administator Mashelia Aungan. LPA Bunker explained the purpose of today's visit. The investigation consisted of the following: Interviews conducted. LPA Bunker asked questions relevant to the nature of the complaint. Ms. Mashelia and LPA Bunker toured the buildings and grounds to observe and identify any signs of neglect, abuse, or other immediate health and safety threats. We did not observe any signs of neglect or abuse during today's visit. LPA Bunker requested and reviewed resident 1's (R1) records and requested copies of supporting documents. Due to insufficient information available at this time, the above allegations need further investigation. There were no deficiencies cited. Exit interview conducted.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) -40-7397
LICENSING EVALUATOR NAME: Regina Cloyd	TELEPHONE: 323-981-7155
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2024

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 3

Control Number 11-AS-20230828142032

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BENTLEY MANOR	FACILITY NUMBER: 198320301
	VISIT DATE: 08/09/2024

NARRATIVE

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Allegation(s): Staff do not ensure that resident's incontinence needs are met.

The investigation revealed the following: Regarding the allegation "Staff do not ensure that resident's incontinence needs are met,” it is being alleged that Resident #1’s (R1) underwear is left soiled in feces and urine. In addition R1 has two open wounds on R1’s backside and one is a result of staff not changing R1. On 08/09/24, LPA Cloyd observed that the facility remained free of odors from incontinence. Three (3) out three (3) residents indicated that staff regularly assist them with incontinence needs and there are no complaints. Seven (7) out of seven (7) staff members, including the Administrator, indicated that residents are changed 2-3 times during the day and whenever residents have an emergency. The Administrator indicated R1 followed the same incontinence schedule and that staff made sure that R1 was changed before third-party agencies arrived.

Regarding the allegation, “Staff do not ensure that resident's incontinence needs are met,” based on the interviews and observations, the Department 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, as a result, the allegation is Unsubstantiated.

Allegation(s): Staff do not maintain facility clean and sanitary at all times.

The investigation revealed the following: Regarding the allegations "Staff do not maintain facility clean and sanitary at all times,” it is being alleged that food trays are left on the counters attracting rats. On 08/09/24, LPA Cloyd did not observe trays, but tableware placed on carts to transport food to the first and second floor dining table. Plates were either walked to the kitchen by staff or placed on the cart until everyone finished their lunch. LPA observed a resident eating in his room and the tableware was removed upon completion. Six (6) out six (6) residents indicated that plates are removed from the eating area quickly. Seven (7) out of seven (7) staff members, including the Cook, indicated that plates are removed quickly, the common areas and resident rooms are cleaned daily, and they have not seen rats. The Administrator indicated that staff sweep at night because some residents like to eat and drop crumbs. LPA observed the facility to be clean and sanitary.

Continue to LIC9099-C.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) -40-7397
LICENSING EVALUATOR NAME: Regina Cloyd	TELEPHONE: 323-981-7155
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20230828142032

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: BENTLEY MANOR	FACILITY NUMBER: 198320301
	VISIT DATE: 08/09/2024

NARRATIVE

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Regarding the allegation, “Staff do not maintain facility clean and sanitary at all times,” based on the interviews and observations, the Department 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, as a result, the allegation is Unsubstantiated.

Allegation(s):

Staff are not addressing rodent problem.

The investigation revealed the following: Regarding the allegations, “Staff are not addressing rodent problem,” it is being alleged that rats enter the facility and leave droppings. On 08/09/24, LPA Cloyd did not observe rat droppings in resident #1’s (R1) former bathroom nor in the facility. Eight (8) out of nine (9) resident interviews indicated that they have not seen rats in the facility. All staff interviews indicated that the facility does not have a rodent problem. Record review reveals that the facility receives monthly pest control as of 2006. Interview with the Administrator indicated that a special pest control service was added once she learned about the rat allegation in September 2023.

Regarding the allegation, “Staff are not addressing rodent problem,” based on the interviews, observations, and record reviews, the Department 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, as a result, the allegation is Unsubstantiated.

No deficiencies were cited for these allegation(s).

An exit interview was conducted and a copy of this report was provided to the Administrator Mona Alcaraz.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) -40-7397
LICENSING EVALUATOR NAME: Regina Cloyd	TELEPHONE: 323-981-7155
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2024

LIC9099 (FAS) - (06/04)

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