198320302-8-28-2023-11-AS-SCIS-CVLSUG-20230912141104

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320302
Report Date: 04/11/2023
Date Signed: 08/28/2023 02:36:49 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
12/06/2022 and conducted by Evaluator Pamela Bunker

COMPLAINT CONTROL NUMBER: 11-AS-20221206083610

FACILITY NAME:	BENTLEY SUITES		FACILITY NUMBER:	198320302
ADMINISTRATOR:	AQUINO, ROBIN		FACILITY TYPE:	740
ADDRESS:	851 4TH STREET		TELEPHONE:	(213) 478-0460
CITY:	SANTA MONICA	STATE: CA	ZIP CODE:	90403
CAPACITY:	44	CENSUS: 33	DATE:	04/11/2023
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Robin Aquino and Nassir Cenizal.		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff spoke inappropriately to resident in care

INVESTIGATION FINDINGS:

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*** This amended Complaint Investigation Reports LIC9099 and LIC9099-C dated 08/23/2023 superseded the original LIC9099 and LIC9099-C reports dated 04/11/2023 ***
Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint visit on Tuesday, April 11, 2023. Upon arrival at the facility. LPA Bunker called the facility via telephone and conducted a Risk Assessment. Based on the assessment, the facility is not cleared of COVID-19 infection. LPA Bunker met with Caregiver Nassir Cenizal. LPA Bunker explained the purpose of today's visit.

The investigation consisted of the following: During the course of the investigation on December 13, 2022, and April 11, 2023. Interviews were conducted with staff 1-2 (S1-S2) and residents (R1-R3). LPA Bunker asked questions relevant to the nature of the complaint. Regional Facility Director Robin Aquino and LPA Bunker toured the facility 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 the visits. LPA Bunker requested copies of supporting documents.
See continued LIC9099-C page 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Pamela Bunker	TELEPHONE: (323) 213-1113
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023

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-20221206083610

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: BENTLEY SUITES	FACILITY NUMBER: 198320302
	VISIT DATE: 04/11/2023

NARRATIVE

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Continued LIC9099-C page 2
*** Please note this is an amended copy of the LIC9099-C page 2 that supersedes the original copy date 04/11/2023***
Allegation: Staff spoke inappropriately to the resident in care
Staff 1-2 (S1-S2) and residents 2-3 (R2-R3) stated staff do not speak inappropriately to residents in care. S1 Regional Facility Director Robin Aquino stated resident 1 (R1) is the person who speaks inappropriately to the staff and the residents. S1 stated that R1 failed to comply with verbal abuse rules and guidelines. R1 stated that he was accused of being verbally abusive towards the facility staff. R1 stated that the facility wanted to remove all the items from his room to clear the bedbug issue and staff accused him of causing the bedbug problem due to not keeping himself and his room clean. R1 stated staff made false accusations against him and called the police on him for his behavior. R1 stated the facility staff called the police on him and the cops verbally interrogated him. R1 stated staff made false accusations against him and called the police. R1 stated he doesn't want to complain against the staff. S1-S2 and R2-R3 stated staff treat residents with dignity and respect and denied the allegation.

Investigation revealed the following: Staff 1-2 (S1-S2), and residents 2-3 (R2-R3) stated staff do not speak inappropriately to residents. S1-S2 and R2-R3 stated residents are treated with dignity and respect. S1-S2 and R2-R3 stated residents are safe, healthy, and provided with comfortable accommodations. S1 Ms. Aquino stated that R1 failed to comply with the health and safety of other residents at the property. S1-S2 stated that R1 was verbally abusive towards the facility staff. S1-S2 and R2-R3 stated residents are free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature. S1-S2 stated that R1 failed to comply with general hygiene requirements and failed to comply with verbal abuse rules and guidelines at the facility. R1-R3 stated their daily needs are being met. R1-R3 stated that they were happy living at the facility. R1 stated he like living in this area because it is safe and within walking distance of the beach. S1-S2 and R2-R3 denied the allegation.
Based on interviews, available evidence, observation, information received, and records reviewed there was not enough sufficient evidence to support the allegation. 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 deemed unsubstantiated.
A copy of the Complaint Investigation Report LIC9099 and LIC9099-C provided to the facility Administrator
There were no deficiencies cited. An exit interview was conducted.

SUPERVISOR'S NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7743
LICENSING EVALUATOR NAME: Pamela Bunker	TELEPHONE: (323) 213-1113
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2023

LIC9099 (FAS) - (06/04)

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