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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 01/30/2024
Date Signed: 01/30/2024 11:42:04 AM

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
01/25/2024 and conducted by Evaluator Glenn Trueman
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240125083727
FACILITY NAME:PICO RIVERA GARDENSFACILITY NUMBER:
198600539
ADMINISTRATOR:MEIR SHAUL YITZI TEICHMANFACILITY TYPE:
735
ADDRESS:6525 ROSEMEAD BLVD.TELEPHONE:
(562) 949-8489
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY:185CENSUS: 44DATE:
01/30/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Administrator Andrew De VeraTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff did not take proper steps to prevent the spread of bed bugs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Glenn Trueman conducted an unannounced complaint investigation visit for the allegation above. LPA met with Administrator Andrew De Vera and the purpose of the visit was discussed.

LPA conducted the following on todays visit: Toured the physical plant with a random sample of client rooms which were Rooms 12, 35, 41, 56, 106, 109, 206, and 215. Interviewed staff #1 (S 1) and interviewed clients #1- 6 (C1-C6). LPA reviewed and collected a copy of the staff and client rosters as well as the records of pest control. The investigation revealed the following:

In regards to the allegation staff did not take steps to preevent the spread of bed bugs, based on interviews conducted and information gathered Administrator stated that the pest control company has visited the facility 2x a week to treat for bed bugs and roaches.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2024
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 2
Control Number 28-AS-20240125083727
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: 01/30/2024
NARRATIVE
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Documentation provided shows that Dewey Pest Control treated the facility in the kitchen, laundry room, restrooms and client rooms on 01/19/24, and 01/26/24.
Administrator stated that pest control were coming 2 x a month and he changed the contract to 2x a week for a month.
Staff S 1 stated that pest control comes weekly and if a client had bed bugs he would also use spray for bed bugs.
LPA on tour of rooms did not observe any bed bugs, roaches or any insects.
Interviews with Client's C1- C8 all stated that pest control are fumigating their rooms. All stated they are told to put clothes on their bed and cover it.
All 8 stated that facility are taking measures to treat pests and that pest control are here weekly.

Based on the interviews conducted with the staff and clients and documents reviewed and LPA's observation, 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 allegation is UNSUBSTANTIATED.

Exit interview was conducted with Andrew De-Vera and a copy of this report was provided.
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Glenn Trueman
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 01/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2