198600539-2-15-2023-28-AS-RORN-CZTM6C-20240125081937

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 02/15/2023
Date Signed: 02/15/2023 04:29:20 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
02/08/2023 and conducted by Evaluator Alma Gonzalez

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230208122650

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: 164	DATE:	02/15/2023
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Yitzi Teichman		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Staff do not provide the residents access to a telephone
Staff behavior poses as a risk to the residents
Staff pushed a resident while in care
Staff do not prevent residents for disrupting other residents while in care
Staff deny the residents access to water while in care
Staff retaliate against the residents while in care

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 Yitzi Teichman and explained the reason for the visit.

The investigation consisted of: LPA conducted interviews with Administrator Yitzi Teichman, Assistant Administrator Andrew De Vera, Staff 1-4 (S1-4) and Clients 1-10 (C1-10). LPA collected copies of Staff and Client Rosters. LPA reviewed C1s file and collected copies of facility documents relevant to the investigation. LPA additionally conducted a tour of the facility which included observations of a random selection of client rooms in both buildings A and B, laundry rooms in both buildings A and B, outside patio and facility lobby.

(See LIC9099C for continuation)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Alma Gonzalez	TELEPHONE: (323) 981-3973
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 5

Control Number 28-AS-20230208122650

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: 02/15/2023

NARRATIVE

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Investigation revealed the following: Regarding allegation, Staff do not provide the residents access to a telephone, it is alleged that facility does not provide a phone for clients to receive incoming calls or to make outgoing calls. Interviews conducted with facility staff revealed that the facility does provide a telephone for clients to make and receive calls. Facility staff stated that the telephone is located in the lobby. 9 out of 10 facility clients stated that the facility does provide a telephone for their use. They stated they receive calls and can also make outgoing calls. 9 out of 10 clients stated that they own a private cell phone but can use the facility phone if they need to. 1 out of 10 clients stated that their cell phone is not working at the moment and they have a hard time getting access to use the facility telephone due to other clients also using it. During the time of the visit, LPA observed a working phone located in the lobby and observed clients actively using it. Based on statements gathered from interviews conducted with staff and clients and LPA observations there was not enough supportive evidence to concur with the reported allegation.

For allegation, Staff behavior poses as a risk to the residents, it is alleged that facility staff constantly bicker and argue amongst each other. Interviews conducted with facility staff revealed that the facility staff do not argue or bicker amongst each other at any time. 9 out of 10 facility clients stated that they have not seen facility staff argue or bicker amongst each other. 1 out of 10 clients stated that they have observed staff argue with each other. During the time of the visit, LPA did not observe any facility staff arguing or bickering amongst each other. LPA observed staff interacting with each other in a respectful manner. Based on statements gathered from interviews conducted with staff and clients and LPA observations there was not enough supportive evidence to concur with the reported allegation.

For allegation, Staff pushed a resident while in care, it is alleged that a facility staff pushed a client who was holding hot coffee. Interviews conducted with facility staff revealed that facility staff have never pushed a client that was holding a hot liquid. Staff denied any incident of physical abuse towards clients. 9 out of 10 facility clients stated that facility staff are professional and have never pushed them and they have never seen or heard of any staff pushing anyone holding a hot beverage. 1 out of 10 clients stated that they have observed one staff member push a client holding a coffee but that the client down played the situation. During time of the visit, LPA did not observe any facility staff physically pushing any facility client. LPA observed staff interacting with clients in a respectful manner. Based on statements gathered from interviews conducted with staff and clients and LPA observations there was not enough supportive evidence to concur with the reported allegation.

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Alma Gonzalez	TELEPHONE: (323) 981-3973
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 5

Control Number 28-AS-20230208122650

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: 02/15/2023

NARRATIVE

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For allegation, Staff do not prevent residents for disrupting other residents while in care, it is alleged that a facility staff allow clients to play loud music past 10:00 p.m. Interviews conducted with facility staff revealed that facility staff do not allow clients to play loud music past 10:00pm. Staff stated that clients are allowed to listen to music but at an adequate volume which will not disrupt other clients. Staff stated that if any client is listening to loud music they are told to lower the volume and/ or use their headphones. 9 out of 10 facility clients stated that facility staff do not allow clients to disrupt other clients. They stated that if anyone is being loud or is playing loud music staff will ask them to lower the volume and/ or keep their tone of voice down. 1 out of 10 clients stated that there are times when some clients play loud music and staff have to constantly tell them to lower the volume. 1 out of 10 clients stated that they have played loud music past 10:00pm on one occasion and were immediately told by staff that they had to lower their volume. They stated that they obliged and have not played loud music after 10:00pm anymore. During time of the visit, LPA did not observe any facility client playing loud music or engaging in disruptive behavior. Based on statements gathered from interviews conducted with staff and clients and LPA observations there was not enough supportive evidence to concur with the reported allegation.

For allegation, Staff deny the residents access to water while in care, it is alleged that there is no drinking water available to clients between the hours of 10:00 a.m. - 9:00 p.m. Interviews conducted with facility staff revealed that drinking water is provided for clients at all times. Staff stated that there are always two water cooler dispensers with drinking water located in the lobby as well as additional 5 gallon water containers to be used to refill the water containers when they run out. 9 out of 10 facility clients stated that there is always water available for them. 1 out of 10 clients stated that there are times when the water cooler containers are not refilled. During time of the visit, LPA observed two water cooler containers as well as three additional 5 gallon water bottles located in the lobby. LPA observed that both water coolers had water in them. Based on statements gathered from interviews conducted with staff and clients and LPA observations there was not enough supportive evidence to concur with the reported allegation.

For allegation, Staff retaliate against the residents while in care, it is alleged that clients fear retaliation from staff as staff have been known to retaliate against clients in care. Interviews conducted with facility staff revealed that facility staff do not retaliate against clients in care. Staff stated that they are aware that it is a client's right to file a complaint or speak up if they feel that they have to and if they have any concerns regarding the facility and/ or facility staff. Interviews conducted with 9 out of 10 facility clients revealed that

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Alma Gonzalez	TELEPHONE: (323) 981-3973
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2023

LIC9099 (FAS) - (06/04)

Page: 3 of 5

Control Number 28-AS-20230208122650

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: 02/15/2023

NARRATIVE

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facility staff do not retaliate against clients if they believe that a client is calling in complaints. They also stated that facility staff are respectful and professional. 9 out of 10 clients stated that they are aware that they can call in any concerns to Community Care Licensing Division (CCLD) and stated that they can also let their case worker know if they have any concerns regarding the facility and/ or facility staff. During the time of the visit, LPA did not observe staff speaking inappropriately to clients. Based on statements gathered from interviews conducted with staff and clients there was not enough supportive evidence to concur with the reported allegation.

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.

Exit interview held. A copy of the report was provided to Administrator Yitzi Teichman.

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Alma Gonzalez	TELEPHONE: (323) 981-3973
LICENSING EVALUATOR SIGNATURE:	DATE: 02/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2023

LIC9099 (FAS) - (06/04)

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