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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 02/15/2024
Date Signed: 02/15/2024 02:54:30 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
02/12/2024 and conducted by Evaluator Alma Gonzalez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240212115207
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: 149DATE:
02/15/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Andrew De-VeraTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff do not ensure that client has comfortable accommodations while in care.
Staff do not serve clients adequate amounts of food.
Facility does not have an adequate amount of staff to meet clients' needs.
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 allegations. 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 1-4 (S1-4) and Clients 1-14 (C1-14). LPA collected copies of Staff and Client Rosters and facility food menus from 12/31/23 - 02/24/24. LPA additionally conducted a tour of the facility. The tour included observations of outside patio, medication room, facility lobby, dining room, kitchen which included facility food storage and a total of 7 client rooms.



(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: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024
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 3
Control Number 28-AS-20240212115207
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: 02/15/2024
NARRATIVE
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Investigation revealed the following: Regarding allegation, Staff do not ensure that client has comfortable accommodations while in care, it is alleged that client room(s) are very hot and clients are not able to control the AC or heater. Interviews conducted with facility staff revealed that temperature at the facility including client rooms is set at comfortable levels at all times. Staff stated that if a client reports that their room is too hot or too cold staff will adjust the temperature and check if anything needs repair. Staff stated that the AC and heating at the facility is working and it is not in need of repair at the moment. Facility staff stated that when it is very hot outside they will set the temperature at an appropriate level based on the outside temperature. Interviews conducted with 12 out of 14 clients revealed that facility temperature is always comfortable and they have never felt too hot in their rooms or anywhere in the facility. 1 client ended their interview and 1 client did not want to be interviewed. LPA toured the facility which included all floors, observed facility temperature and observed that temperature was set at an appropriate and acceptable range. During the tour conducted, LPA observed the facility temperature to be comfortable on all facility floors as well in a total of 7 client rooms. Based on interviews conducted with facility staff, facility clients, and LPA observations, there was not enough supportive evidence to concur with the reported allegation.

For allegation, Staff do not serve clients adequate amounts of food, it is alleged that on 02/09/24 the facility only served noodles and nothing else. Interviews conducted with facility staff revealed that clients are served adequate amounts of food at each meal. Staff deny that clients are only served noodles and nothing else. Staff stated that all meals served at the facility are of adequate amounts and clients can also request additional servings of food once all clients have been served and received their meals. Staff also stated that clients can also request substitutions if they do not want to eat what is being served. Administrator stated that the facility food consumption calls for a weekly order. Interviews conducted with 10 out of 14 facility clients stated that they are satisfied with the food service and stated that they are served adequate amounts of food and they may request substitutions or additional servings. 1 client ended their interview and 1 client did not want to be interviewed. 2 clients stated that they prefer to eat outside of the facility but do eat at the facility sometimes and they do not have any complaints. During the time of the visit, LPA observed facility food storage and observed that the facility has an adequate amount of food in storage. LPA observed that lunch was being prepared and the lunch meal was what is listed on the facility menu. LPA observed the lunch meal and it appeared to have adequate amounts of food. LPA also observed required amount of perishables and non-perishables. Based on statements gathered from interviews conducted with staff and clients, as well as LPA observations there was not enough supportive evidence to concur with the reported allegation.
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Alma Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20240212115207
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: 02/15/2024
NARRATIVE
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For allegation, Facility does not have an adequate amount of staff to meet clients' needs, it is alleged that facility does not have enough staff to assist the clients, staff threaten clients with eviction and staff do not treat all clients fairly as some staff bring clients their medications to their rooms while other clients are made to go to the medication room. Interviews conducted with facility staff revealed that there are enough staff on schedule to meet the needs of clients in the facility. Administrator stated that he always ensures that the facility is fully staffed to provide proper care and supervision to meet the client's needs. Staff stated that if a client is not following the house rules they are privately told that they can be evicted if the behavior continues but they never threaten clients with eviction. Staff stated that they never deliver medications to client rooms and stated that all clients are called on the intercom when they have to come to the medication room to get their medications. They stated that staff will go remind clients that it is time to take their medications, and staff will also check on clients if they do not respond to the calls to ensure that the client is safe or if the client is out of the facility. Interviews conducted with 13 out of 14 facility clients stated that there is enough staff on schedule to meet their needs and to supervise them. 1 client stated that they think there are not enough staff on schedule to meet client's needs and feels there should be more staff during the night shift. LPA reviewed facility schedule and observed that the facility has enough staff on schedule to properly oversee clients, facility operation and tend to clients daily needs. Based on interviews conducted with facility staff, facility clients, and LPA record review, 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 Andrew De-Vera.
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Alma Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/15/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3