198600539-9-15-2023-28-AS-FFIS-CZ5RAL-20240103115119

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 09/15/2023
Date Signed: 09/15/2023 03:38:33 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
09/13/2023 and conducted by Evaluator Valeria Maldonado

COMPLAINT CONTROL NUMBER: 28-AS-20230913095204

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: 138	DATE:	09/15/2023
		UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Andrew De Vera- Administrator		TIME COMPLETED:	03:40 PM

ALLEGATION(S):

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Staff do not provide a safe environment for residents.
Staff speak inappropriately to resident.
Staff do not prevent residents from smoking in nonsmoking areas.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) V. Maldonado made an unannounced complaint visit at the facility for the purpose of investigating the above-mentioned allegations. LPA Maldonado met with Administrator, Andrew De Vera, and explained the purpose for the visit.
During today's visit, LPA Maldonado obtained a copy of the client and staff roster, observed common areas, designated smoking areas, outer balconies of client rooms, and conducted interviews with Staff# 1-4(S1-S4) and Clients# 1-11(C1-C11).
The investigation revealed the following:
Regarding allegation: Staff do not provide a safe environment for residents.
It is alleged that staff do not intervene in altercations between residents, although there is a history of violence and fighting between residents. It is also alleged that a client was threatened by an unknown resident on 9/13/23, while in the elevator, and staff was notified but did not do anything about it. Per interviews conducted, (10) of (11) clients stated to be unaware of an incident that occurred on 9/13/23 where a client threatened another client in the elevator. (Report Continued on LIC9099-C...)

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Valeria Maldonado
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2023

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-20230913095204

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: 09/15/2023

NARRATIVE

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The clients also stated that if fights/arguments start between clients, they notify staff and staff will separate the clients and call the police if needed. C1 stated to have been approached by an unknown client as they wanted to speak to C1- C1 cannot recall what about. C1 stated to not want to speak to the other client and C1 then called the police. C1 could not provide details of what the threat was, but stated the police informed C1 to notify staff if the client did anything "vicious" to C1 and to have staff call the police. (4) of (4) staff denied the allegation and stated to be unaware of a client threatening another client on 3/19/23 in an elevator. Staff stated when fights between clients are observed/made aware of them, they separate clients, de-escalate the situation, and call the police, if needed. This allegation is Unsubstantiated.
Regarding allegation: Staff speak inappropriately to residents.
It is alleged that C1 was criticized by staff when C1 asked staff to turn down the volume of the speakers in the building and was told, "you need to have your ears checked." Per interview with C1, C1 states to feel that staff are playing "mind games" and are "criticizing" C1 because their statement to C1 was "not nice", as C1 feels there is nothing wrong with their ears. (10) of (11) clients interviewed denied the allegation. (4) of (4) staff denied the allegation and stated that C1 always makes this allegation directly to them a lot. This allegation is Unsubstantiated.
Regarding allegation: Staff do not prevent residents from smoking in nonsmoking areas.
It is alleged that facility staff are allowing residents to smoke marijuana, cigarettes, and “spice” in areas of the facility that are designated as nonsmoking. During the observation of the common areas, designated smoking areas, and outer balconies of client rooms, LPA did not note the smell of other substances inside or outside the building other than the smell of cigarettes. LPA also observed clients smoking outside the building in the patio/designated smoking areas, and smoking in their balconies. No client was observed smoking inside the building. Per interviews conducted, (4) of (4) staff stated clients are aware of the house rules and drugs are not permitted in the facility. It was also stated that clients are aware of the designated smoking areas and if clients are found smoking inside, they are stopped and redirected to smoke outside. (10) of (11) clients interviewed stated to not be aware of clients smoking illegal substances in the building, but have observed other clients smoking inside. When seen, Staff are notified and staff will stop those clients from smoking and tell them to go outside to smoke. This allegation is Unsubstantiated.

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.
Per California Code of Regulations, Title 22, no deficiencies were observed or cited during today's visit.
Exit interview was conducted with Administrator Andrew De Vera, and a copy of the report was issued.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Valeria Maldonado
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2023

LIC9099 (FAS) - (06/04)

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