198600539-2-22-2023-28-AS-RORN-CPJUN9-20230302144334

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 02/22/2023
Date Signed: 02/22/2023 06:11:47 PM

Unsubstantiated

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 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
02/17/2023 and conducted by Evaluator Jose Villalobos

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230217091608

FACILITY NAME:	PICO RIVERA GARDENS		FACILITY NUMBER:	198600539
ADMINISTRATOR:	MEIR SHAUL YITZI TEICHMAN		FACILITY TYPE:	735
ADDRESS:	6525 ROSEMEAD BLVD.		TELEPHONE:	(562) 949-8489
CITY:	PICO RIVERA	STATE: CA	ZIP CODE:	90660
CAPACITY:	185	CENSUS: 168	DATE:	02/22/2023
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Adminsitrator Yitzi Teichman		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Facility staff allow residents to smoke inside of the facility
Staff do not treat resident with respect

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jose Villalobos conducted an initial complaint investigation for the allegations above. LPA met with Administrator Yitzi Teichman and the purpose of the visit was discussed.

During todays investigation, LPA toured the physical plant including rooms #46 and #44, interviewed clients #1-16 (C1-C16), and interviewed staff #1-#6 (S1-S6). LPA also collected documents from C1's file as well as resident council agenda and the Staff and client rosters. The investigation revealed the following:

In regards to the allegation "Facility staff allow residents to smoke inside of the facility" it was alleged that client #2 smokes inside the facility and staff allow it. (16) of (16) clients interviewed denied the allegation. (6) of (6) Staff interviewed denied the allegation. Interviews show that clients are informed by staff that smoking is not allowed inside the facility and inside rooms. There are designated areas where clients can smoke outside the building as well as on the balconies with screens closed behind them....

Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Jose Villalobos
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2023

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 28-AS-20230217091608

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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: PICO RIVERA GARDENS	FACILITY NUMBER: 198600539
	VISIT DATE: 02/22/2023

NARRATIVE

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Interviews with clients confirmed that staff do not allow clients to smoke inside the facility. C2 denied smoking inside the facility. LPA toured the physical plant and did not observe clients smoking in their rooms or in the building. Based on LPA's observations and interviews; 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.

In regards to the allegations "Staff do not treat resident with respect" it was alleged that facility staff raise the volume on intercoms systems really loud hurting C1 and not treating C1 with respect. (15) of (16) Clients interviewed could not corroborate the allegation. (6) of (6) Staff interviewed denied the allegation. Interviews did not show that staff speak disrespectfully to C1. Interviews do not show that staff raises the volume on the intercoms or yell into the intercoms to hurt clients in care. During the visit, LPA did not observe the speakers to be loud and hurtful. Based on LPA's observations and interviews; 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.

Exit interview was conducted and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Jose Villalobos
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 02/22/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/22/2023

LIC9099 (FAS) - (06/04)

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