198600539-7-22-2024-28-AS-DSIS-D7JVPG-20240726163644

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 07/22/2024
Date Signed: 07/22/2024 03:36:12 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
06/05/2024 and conducted by Evaluator Tena Herrera

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240605114939

FACILITY NAME:	PICO RIVERA GARDENS		FACILITY NUMBER:	198600539
ADMINISTRATOR:	SANTOS DOMINGUEZ		FACILITY TYPE:	735
ADDRESS:	6525 ROSEMEAD BLVD.		TELEPHONE:	(562) 949-8489
CITY:	PICO RIVERA	STATE: CA	ZIP CODE:	90660
CAPACITY:	185	CENSUS: 136	DATE:	07/22/2024
		UNANNOUNCED	TIME BEGAN:	09:32 AM
MET WITH:	Tony Olmos - Administrator		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Staff withheld resident funds.
Staff do not keep the resident's room clean and sanitary.
Staff do not provide linens for residents in a timely manner.
Staff do not provide toiletries for residents in a timely manner.
Staff speak inappropriately to resident in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tena Herrera conducted an subsequent complaint visit to investigate the above allegations. The purpose of the visit was discussed with Administrator Tony Olmos.

The investigation consisted of the following:

LPA obtained copies of both client and staff rosters, a tour of the facility with focus on client bedrooms was conducted, a total of 6 client rooms were toured, along with facilities linen closet. LPA conducted interviews with 5 staff and 10 residents during todays visit.

(continued on LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2024

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 4

Control Number 28-AS-20240605114939

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: 07/22/2024

NARRATIVE

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The investigation revealed the following:
Allegation: Staff withheld resident funds.
It is alleged that S1 is withholding C1’s funds as a check sent to C1 from their conservator and the funds have not been given to C1.
LPA interviewed C1 and client confirmed that their funds have been given to them, they stated it did take a while for the funds to be cashed and distributed but since this complaint was filed funds were provided. LPA spoke with S1 and it was revealed that S1 does not handle any financing, however, there was a time that they covered that area but all they did was distribute the funds that were told to be given out since the person who normally does it was out. During interview with S4, staff stated that the funds get distributed typically on Wednesday’s to the clients but this will very as some prefer to get one lump sum given at the beginning of the month and others may have orders from their responsible party on how to distribute funds. They further stated that C1 hasn’t complained about this to them and have been receiving their funds monthly. LPA interviewed 10 clients and 9 out of 10 clients stated that they have no issues with receiving their funds and confirmed that every Wednesday funds are distributed.

Allegations: Staff do not keep the resident's room clean and sanitary. Staff do not provide linens for residents in a timely manner. Staff do not provide toiletries for residents in a timely manner.
It is alleged that C1’s assigned housekeeper S2 has not cleaned their room in a while, C1 is not being provided with clean towels, sheets or toilet paper and it takes housekeeping 2-3 days to provide toiletries and linens.
LPA toured C1’s room and room appeared to be clean and well maintained with sufficient amount of toilet paper and clean towels. There was a total of 6 client rooms toured during investigation (all rooms are cleaned by S2) and all appeared to have clean linens, towels and toiletries. 1 out of the 6 rooms did appear to be dirty, however, C6 stated the room was like that because their roommate made it that way and it was not due to neglect of the housekeeper.

(Continued on LIC9099-C)

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 28-AS-20240605114939

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: 07/22/2024

NARRATIVE

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LPA interviewed S2 and staff stated that there have been issues with C1 in the past about the housekeeping not being done, however, they denied the allegation stating that C1 and their roommate tell S2 not to clean certain things or areas making it difficult to do a thorough job of cleaning. S2 further stated that linens and towels are given weekly or as needed and toilet paper is refilled daily or as needed. LPA interviewed 10 clients and 7 out of 10 clients denied the above allegations and stated that their rooms are cleaned at least once weekly and provided with clean towels and linens once weekly, clients stated that trash is taken out daily and toilet paper is given daily or as needed. LPA interviewed 5 staff and 5 out of 5 staff denied the above allegation and stated that housekeeping is done regularly, deep cleaning is once monthly and linens/towels/sweep/mop/bathroom cleaning is done once weekly. During interview with S4, staff stated that they had a conversation with C1 last week and due to the continuous complaints they will be switching the housekeeper to a different staff which will be in affect as of next week. S4 further stated that they have investigated these complaints by checking C1’s room on different occasions and have not seen any neglect on the housekeepers behalf. LPA toured linen closet and there was sufficient amount of linens observed to accommodate weekly linen change.

Allegation: Staff speak inappropriately to resident in care.
It is alleged that staff are very rude to clients and have called clients mean names.
LPA interviewed C1 and C1 stated that the remarks weren’t made about them but about another client, C2 confirmed they heard the same remark. LPA interviewed S4 and S4 denied the allegation and stated that they have never made any remarks like these towards clients or staff and give everyone dignity and respect. LPA interviewed a total of 10 clients during todays visit and 8 out of 10 stated that they have never heard staff call another client any names and they have never been mistreated like this by staff, however, they did state that sometimes the tone of voice may sound mean or rude but could not confirm if this was intentional. LPA interviewed a total of 5 staff and 5 out of 5 staff denied the above allegation and stated that they have never called a client a mean name and have never observed another staff do this either.
(Continued on LIC9099-C)

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 28-AS-20240605114939

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: 07/22/2024

NARRATIVE

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Based on statements and interviews conducted with staff and clients, tour of client rooms and linen supply, there was not enough supportive evidence to concur with the reported allegations.

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, and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Tena Herrera
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/22/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2024

LIC9099 (FAS) - (06/04)

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