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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 01/19/2023
Date Signed: 01/19/2023 02:05:29 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/11/2023 and conducted by Evaluator Cynthia D Chan
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20230111134403
FACILITY NAME:PICO RIVERA GARDENSFACILITY NUMBER:
198600539
ADMINISTRATOR:MEIR SHAUL YITZI TEICHMANFACILITY TYPE:
735
ADDRESS:6525 ROSEMEAD BLVD.TELEPHONE:
(562) 949-8489
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY:185CENSUS: 165DATE:
01/19/2023
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Julia Elias, SupervisorTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Facility appliances are in disrepair.
Staff yell at client(s) in care.
Facility does not have enough staff to meet the needs of clients in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cynthia Chan conducted a complaint investigation for the allegations listed above. LPA arrived unannounced and met with Staff, Julia Elias, and explained the reason for the visit.

The investigation consisted of the following:
LPA Chan obtained copies of the Staff and Client rosters and conducted a tour of the laundry areas in the building. Interviews were held with the Assistant Administrator, 6 Staff, and 15 Clients.

The investigation revealed the following:
Allegation - Facility appliances are in disrepair. It is alleged that the washer and dryer are not working. The Assistant Administrator and Staff indicated that the washers and dryers appear to work properly at this time. They stated that when washers and dryers are reported to be in disrepair, they place a service order right away with the contracted laundry machine company. The most recent work order for the laundry machine was serviced on 1/6/23. (Continue on LIC9099C)
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023
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 2
Control Number 28-AS-20230111134403
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: PICO RIVERA GARDENS
FACILITY NUMBER: 198600539
VISIT DATE: 01/19/2023
NARRATIVE
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The maintenance staff also stated that the laundry machines are sometimes unplugged by the clients or that the washers take a little bit longer to start up, however, they are not malfunctioned. Per staff, they will put up a note indicating when the machines are out of order. LPA interviewed a total of 15 clients, and 4 out of the 15 stated that the washer and/or dryer are not working at this time. Majority of the clients stated that when the washers or dryers break down, they will report it to the staff and the machines will be fixed in a timely manner. There are other machines available for use as they are being repaired. LPA toured all the laundry areas in the building and the machines appear to be working. Some of the machines were being used and there were no notes indicating any of them out of order.

For allegation - Staff yell at client(s) in care. Based on interviews conducted with Staff, they do not yell at clients. They treat them with respect and need to be firm with them at times. They stated they have not observed any other staff yelling at clients, but rather, clients yell at them. LPA interviewed 15 clients and all of them stated that the staff do not yell at them or other clients. Some stated that the staff treat them with respect and are firm with clients when they get out of hand. During the visit today, LPA observed a client screaming at the kitchen aide and demanding more coffee. The staff attempted to explain, but the client's anger continue to escalate. The assistant administrator immediately intervened and calm the client.

For allegation - Facility does not have enough staff to meet the needs of clients in care. It is alleged there is not enough staffing and have clients working. Per Staff interviewed, they denied having clients work at the facility. They stated that some clients volunteer to wipe down the tables or mop the floors. There are no clients residing at the facility who requires assistance with their activities of daily living (ADLs), such as dressing, bathing, or eating. The clients are pretty self-sufficient with exception to medication management. They supervise often and provide assistance upon request. 6 out of the 7 Staff interviewed feel there is sufficient staffing to meet the needs of the clients. They have coverage when a staff calls out ill. One feels the facility needs more staff since there are so many clients at the facility. 4 out of the 15 clients interviewed do not feel there is adequate staffing to monitor and meet their needs. Two stated there is not enough staff particularly in housekeeping. They are not able to get additional supplies when requested. Some of the clients, who have observed other clients helping out in the kitchen, have stated they volunteered and not told to do so by the staff. Based on the information gathered, there is insufficient evidence to support this allegation.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.
An exit interview was conducted with Andrew De Vera. A copy of this report along with the appeal rights were provided.
NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/19/2023
LIC9099 (FAS) - (06/04)
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