198600539-11-2-2023-28-AS-RORN-D28MBN-20240207082809

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 11/02/2023
Date Signed: 11/02/2023 01:57:46 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
10/26/2023 and conducted by Evaluator Alma Gonzalez

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20231026101346

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: 147	DATE:	11/02/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Andrew De Vera		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Facility's intercom system is too loud causing discomfort to clients

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced complaint visit to gather information pertaining to the above-mentioned allegation. LPA met with Administrator Andrew De Vera and explained the reason for the visit.

The investigation consisted of: LPA conducted interviews with Administrator Andrew De Vera, Staff 1-3 (S1-3) and Clients 1-14 (C1-14). LPA collected copies of Staff and Client Rosters and conducted a tour of the facility.

Investigation revealed the following: Regarding allegation, Facility's intercom system is too loud causing discomfort to clients, it is alleged that there are big bolted speakers in front of every client's room and the speakers are too loud to the point of causing physical pain to client(s). It is also alleged that some staff

(See LIC9099C for continuation)

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Alma Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2023

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-20231026101346

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: 11/02/2023

NARRATIVE

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scream into the speaker. Interviews conducted with (4) out of (4) staff revealed that the intercom volume is not too loud to the point that it causes discomfort to facility clients or staff. Staff stated that there is only one client that continuously makes complaints about the intercom speaker volume. They stated that this client complains that their ears hurt due to the intercom speaker volume. They stated that the volume of the intercom is set and is not raised to cause any discomfort to any client and that staff do not scream into the speaker but only use it to ensure that the clients take their medications, to inform them if they have a visitor or a phone call and also to inform them of their meals. They also stated that there are some clients that complain that the volume is too low and they at times cannot hear when they are called to come get their medications, if they have a visitor or if they have a phone call. Interviews conducted with (12) out of (14) clients revealed that they do not have any concerns with the volume of the intercom system. (1) client stated that there might be some staff voices that are heard louder than others but not to the point were they are physically impacted or they experience pain in their ears. (12) out of (14) clients stated that they have never been woken up due to the volume of the intercom system or that the volume of the speakers causes them any pain. (2) out of (14) clients stated that the volume is too loud to the point that they experience pain in their ears. LPA toured the facility and observed that the intercom system announcements appeared to be at a comfortable volume and staff did not speak loud into the speaker. LPA did not observe any clients complaining or expressing any concerns or informing staff that they were in pain due to the volume of the intercom system.

Based on statements gathered from interviews conducted with staff, clients and LPA observations, there was not enough supportive evidence to concur with the reported allegation. 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. A copy of the report was provided to Administrator Andrew De Vera.

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Alma Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 11/02/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2023

LIC9099 (FAS) - (06/04)

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