198600539-3-28-2025-28-AS-FFIS-DG7NHF-20250429102837

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 03/28/2025
Date Signed: 03/28/2025 02:06:54 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
03/06/2025 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250306101554

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: 164	DATE:	03/28/2025
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Andrew DeVera, Assistant Administrator		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Staff did not ensure facility intercom was at a comfortable volume for client.
Staff did not ensure consumables provided to client were free from contamination.
Staff spoke to client in an inappropriate manner.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent visit to continue the investigation for the allegations listed above. LPA met with the Assistant Administrator, Andrew DeVera, and explained the reason for the visit.

The investigation consisted of the following:
On 3/10/25, LPA Chan conducted a tour of the facility. LPA collected the staff and client rosters and interviewed Staff. During the visit today, LPA interviewed additional staff and clients #1 - #10.

The investigation revealed the following:
Allegation – Staff did not ensure facility intercom was at a comfortable volume for client. It is alleged that a staff was screaming into the speaker and caused physical pain to Client #1’s ears. LPA interviewed Staff and Clients for this allegation. Administrator and Staff indicated the intercom volume level is set between 1 and 2 to ensure that clients hear the announcements, and they do not shout into the microphone.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2025

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-20250306101554

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: 03/28/2025

NARRATIVE

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The speakers are outside of the rooms, and they feel that the volume is set at the right level, so it is not too loud or soft. During the tour, the intercom was tested and did not appear too loud. Staff stated the speaker outside of room #46 was disconnected about 2 months ago to accommodate the client across the way who stated the volume is too loud. Client was notified prior to turning off the speaker and client understood. LPA interviewed a total of 10 clients. 8 out of the 10 stated the speaker volume does not bother them, and staff are not shouting when they make the announcements. However, 2 clients stated it is too loud. The interviews do not corroborate this allegation.

Allegation - Staff did not ensure consumables provided to client were free from contamination. It is alleged that a staff put a brown powder on a little piece of material in the medication cup and put sharp objects and a rock in the food. During the visit, LPA observed the cook preparing food and the assistant giving out snacks. There did not appear to be any substances besides the main ingredients needed to make the meals. The cleaning products were stored away from the preparation area. The kitchen staff denied contaminating the foods given to the clients. LPA also checked the medication room. Medications are dispensed in a large tray with each client’s name on it. The trays are placed inside the black cabinet and taken out during the distribution times. Staff interviewed denied adding anything to their medication cups. LPA interviewed 10 Clients and 9 of them have not observed their foods or medication being contaminated. The interviews do not corroborate this allegation.

Allegation - Staff spoke to client in an inappropriate manner. It is alleged that staff are yelling, accusing, and trying to frame the client. LPA interviewed the administrator and 6 Staff. They denied yelling, accusing, or speaking inappropriately to clients. They stated when clients yell at them, they do not respond. They are careful with their choice of words they use which could be a trigger to them. They are aware of the clients' behaviors and allow them time to calm down before explaining anything. LPA also interviewed 10 clients. 9 out of the 10 stated the staff are good and do not yell at them. They treat them fairly and communicate with them appropriately.

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.

An exit interview was conducted with Administrator J. Garcia. A copy of this report along with the appeal rights was provided.

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Cynthia D Chan
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 03/28/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2025

LIC9099 (FAS) - (06/04)

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