198600539-7-11-2023-28-AS-LHIS-CTWQBV-20230720120204

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 07/11/2023
Date Signed: 07/11/2023 02:39:53 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
06/23/2023 and conducted by Evaluator Noemi Galarza

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230623135009

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: 145	DATE:	07/11/2023
		UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Andrew De Vera, Assistant Administrator		TIME COMPLETED:	02:40 PM

ALLEGATION(S):

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Staff do not cook foods thoroughly.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Galarza conducted a subsequent complaint visit to investigate the above allegations. The purpose of the visit was explained to Administrative Assistant Christina Vasquez. Administrator Andrew De Vera arrived shortly after.

The investigation consisted of the following: On 6/27/2023, a physical plant inspection of the exterior and interior common areas/hallways and kitchen was conducted. The focus was on maintenance, trash on the floor, smell of the facility, and food preparation and observation of breakfast meal time. Staff (S1-S3) and residents (R1-R2) were interviewed. LIC 500 Personnel Report, resident roster, house rules, and maintenance job description documents were obtained. During today's visit, staff (S4- S6) and residents (R3- R11) were interviewed. Lunch time meal preparation was observed. A physical plant inspection of common areas and exterior physical plant was conducted.

***report narrative continues next page****

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Noemi Galarza
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023

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-20230623135009

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: 07/11/2023

NARRATIVE

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Allegation: Staff do not cook food thoroughly. It is alleged that kitchen staff do not cook bacon, chicken, and chicken patties thoroughly, and that the chicken is served cold. On 6/27/2023 and today, LPA conducted a kitchen inspection to observe food preparation procedures and meal services. The food was cooked thoroughly, dietary food menu is being followed, and the food was served hot. A total of 11 residents were interviewed. Two (2) out of 11 residents reported that the food is sometimes not cooked thoroughly. The majority of the residents reported satisfaction with food and meal service. All staff denied the allegation. Kitchen staff stated that the chicken patties are already fully cooked, they are only reheated, and crispy bacon is only served on Wednesdays. The findings indicate the food served is in compliance with food safety handing requirements.

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.

No Deficiencies cited.

Exit interview was conducted with Assistant Administrator Andrew De Vera. A copy of the report was provided.

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Noemi Galarza
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/11/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2023

LIC9099 (FAS) - (06/04)

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