198600539-10-31-2024-28-AS-RORN-DB7VZQ-20241120155306

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 10/31/2024
Date Signed: 10/31/2024 11:33:49 AM

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
10/23/2024 and conducted by Evaluator Erik Zaragoza

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20241023152141

FACILITY NAME:	PICO RIVERA GARDENS		FACILITY NUMBER:	198600539
ADMINISTRATOR:	JOYCE GARCIA		FACILITY TYPE:	735
ADDRESS:	6525 ROSEMEAD BLVD.		TELEPHONE:	(562) 949-8489
CITY:	PICO RIVERA	STATE: CA	ZIP CODE:	90660
CAPACITY:	185	CENSUS: 133	DATE:	10/31/2024
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Andrew De Vera - Assistant Administrator		TIME COMPLETED:	11:48 AM

ALLEGATION(S):

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Staff are not ensuring resident was given their PNI
Staff are not treating resident with respect

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Erik Zaragoza Luis De Leon conducted an initial complaint visit to address the allegations listed above. LPAs met with Andrew De Vera, assistant administrator for the facility, and explained the purpose of the visit. Administrator Joyce Garcia arrived shortly thereafter.

The investigation consisted of the following: During the visit, LPAs interviewed Clients #1 - 13 (C1 - C13), Staff #1 - 4 (S1 - S4), obtained copies of the staff and client roster, and also the Record of Safeguarded Cash Resources for C1.

The investigation revealed the following: In regards to the allegation that "Staff are not ensuring resident was given their PNI," it is alleged that C1 was not being given their Personal and Incidental (PNI) money from the facility staff when requesting it.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024

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

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20241023152141

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: 10/31/2024

NARRATIVE

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During interviews with the clients, thirteen (13) out of thirteen (13) did not corroborate the allegation. During an interview with C1, they explained that there was a delay in receiving their PNI money, however staff ultimately provided her the money. Another client stated that they do receive their PNI money through the facility staff, and that the staff are good at providing the PNI money to them on time. Other clients stated that they receive their PNI funds from their conservators or family. During interviews with the staff, four (4) out of four (4) did not corroborate the allegation. One staff stated there was a delay in receiving the PNI money from C1's public guardian for the months of September 2024 and October 2024, and for the week of 10/16/2024 the facility did not have the funds to provide C1. The staff went on to say after they obtained the PNI money from C1's public guardian on 10/23/2024, they provided C1 the PNI money for both the weeks of 10/16/2024 and 10/23/2024. During record review of C1's Record of Safeguarded Cash Resources, LPAs observed that C1 was provided double their amount of PNI on 10/23/2024 to make up for the previous missed week.

In regards to the allegation that "Staff are not treating resident with respect," it is alleged that S1 has been treating C1 disrespectfully by intruding on their conversations and giving attitude when C1 asks for their PNI money. During interviews with the clients eleven (11) out of thirteen (13) did not corroborate the allegation. One client stated that they do not have any conflicts with the staff and that they are treated respectfully. Another client interviewed stated that staff treat them in a nice manner and treat the other clients in a nice manner as well. During interviews with the staff. four (4) out of four (4) did not corroborate the allegation. One of the staff members interviewed stated that they have never witnessed other staff treating the clients in a disrespectful manner. Another staff member also stated that they have never witnessed other staff treating clients disrespectfully.

Based on statements and interviews conducted with staff, clients, review of client files and facility file records, 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: Erik Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/31/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/31/2024

LIC9099 (FAS) - (06/04)

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