198600539-4-18-2023-28-AS-RORN-CR8M54-20230425091740

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 04/18/2023
Date Signed: 04/18/2023 12:46:07 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
04/13/2023 and conducted by Evaluator Luis Mora

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230413165212

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:	04/18/2023
		UNANNOUNCED	TIME BEGAN:	09:37 AM
MET WITH:	Yitzi Teichman - Administrator		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Unqualified staff working in facility.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Luis Mora conducted an unannounced initial complaint visit to determine the validity of the above-mentioned allegation. LPA met with Yitzi Teichman (Administrator) and explained the reason for the visit.

The investigation consisted of the following: LPA Mora obtained copies of the client and staff rosters, and interviewed Administrator, Staff 1 - Staff 4 (S1 - S4), Client 1 - Client 10 (C1 - C10). LPA obtained copies of C1 and C2's identification and emergency information, physician report, and appraisal/needs and services plan, and copies of Staff 4 & Staff 5 (S4 & S5) medication training.

The investigation revealed the following: regarding the allegation "unqualified staff working in facility”, it is alleged that the facility is taking advantage of C1 and having her work for the facility 8 hours a day, 4 days a week and getting paid $300. It is also alleged that C1 has no training, has a mental illness and seizures, and the facility should hire staff instead of having C1 work for them. It is believed that there are more clients that are also being taken advantage. (Continued to LIC 9099C)

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Luis Mora
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

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-20230413165212

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: 04/18/2023

NARRATIVE

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Administrator and staff interviewed denied the allegation and stated that C1 volunteers to do minor cleaning duties and that C1 is not on payroll. There are only 2 clients that like to volunteer (C1 & C2) and there is always a staff supervising them. The administrator stated that the psychologist for both of these client have been made aware and are not against it. The most recent Appraisal/Needs and Services plan for both clients state that they like to provide volunteer work for the facility and are not on payroll and it is signed by their psychologist. Interviews with both C1 and C2 revealed that they are not forced and they have chosen to volunteer to do minor cleaning duties such as mopping, sweeping, and cleaning tables. They both claim that it helps them with their mental state and that they are not paid. The other 8 clients interviewed could not corroborate the allegation. All 10 of the clients interviewed stated that there is no staff shortage and that the facility staff have been able to meet their needs.

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 held and a copy of the report was provided

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Luis Mora
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2023

LIC9099 (FAS) - (06/04)

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