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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 10/03/2024
Date Signed: 10/03/2024 04:08:44 PM

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
09/13/2024 and conducted by Evaluator Noemi Galarza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240913154610
FACILITY NAME:PICO RIVERA GARDENSFACILITY NUMBER:
198600539
ADMINISTRATOR:JOYCE GARCIAFACILITY TYPE:
735
ADDRESS:6525 ROSEMEAD BLVD.TELEPHONE:
(562) 949-8489
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY:185CENSUS: 136DATE:
10/03/2024
UNANNOUNCEDTIME BEGAN:
10:33 AM
MET WITH:Joyce Garcia, AdministratorTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Facility did not safeguard client's personal belongings.
Facility staff did not prevent clients from being hit by other clients.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Galarza conducted a subsequent complaint investigation to investigate the above allegations. LPA discussed the purpose of the visit with Administrator Joyce Garcia.

The investigation consisted of: On 9/17/2024, a physical plant tour of the interior, exterior common areas, and former resident (R1's) room was conducted. Resident (R1) files documents and rosters were reviewed and obtained. Resident (R1) no longer lives at the facility. Residents (R2-R13) were interviewed. Resident (R14) refused interview. Staff (S1 & S2) were interviewed. During today's visit, LPA toured the physical plant, conducted record review, and interviewed staff (S3 &S4).

***Narrative continues next page.


Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Noemi Galarza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
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-20240913154610
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: 10/03/2024
NARRATIVE
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Allegation: Facility did not safeguard client's personal belongings. It is alleged that the facility has not fully transferred all of R1's belongings to their new assisted living facility. According to information obtained, R1's sister and LA Public Guardian have taken the resident their belongings, but a blue-tooth speaker, a push broom, a Cal (UC Berkley) sweater, along with 5 library books that totaled $72.21 are missing. A total of 12 residents were interviewed. Four (4) out of 12 residents stated they have had belongings stolen from their rooms. Administration staff stated that on 7/26/2024, R1's Public Guardian came to the facility to pick up the resident's belongings. They took 9 bags, 2 boxes, 2 suitcases, and 1 ironing board. Documentation was provided showing that the Public Guardian and R1's family picked up the resident's belongings.
This allegation was previously investigated under a separate complaint # 28-AS-20240702120510 on 7/9/2024. On that date, LPA inspected R1's room along with Administrator Tony Olmos, and Assistant Administrator Andrew DeVera and observed that the closet door had a lock, which the staff did not have a key for. During that visit, maintenance staff broke the lock and all of the alleged missing items were observed in the closet. Therefore negating the allegation.

Allegation: Facility staff did not prevent clients from being hit by other clients. It is alleged that sometime during Summer 2023, resident (R1) was hit and spit on by 2 males [R7 & R14] that reside at the facility. Resident (R1) was allegedly walking with their partner, and the 2 male residents got upset because R1 is dating outside of their race. The complaint alleges that R14 hit R1 while in the back patio, and on a separate incident R1 was hit in the front area of the board and care facility because their broom accidentally touched R7. It was reported that staff were notified of the incident. A total of 12 residents were interviewed, of which 3 residents reported that resident (R14) is verbally aggressive towards residents and has hit females, R7 has hit residents without cause, and R1 pushed and punched their former roommate. Resident (R7) denied the allegation, and resident (R14) refused to be interviewed. Based on staff interviews, R1 never reported being hit by R7 & R14. No incident reports were found. There is insufficient evidence to corroborate the allegation.

Although the allegation(s) 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 was conducted with Joyce Garcia. A copy of the report was issued.
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Noemi Galarza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024
LIC9099 (FAS) - (06/04)
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