198600539-8-26-2025-28-AS-LHIS-DLBRAZ-20250908125158

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 08/26/2025
Date Signed: 08/26/2025 12:43:55 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
08/21/2025 and conducted by Evaluator Noemi Galarza

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20250821153811

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: 171	DATE:	08/26/2025
		UNANNOUNCED	TIME BEGAN:	08:58 AM
MET WITH:	Joyce Garcia, Administrator		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Staff are mismanaging resident's medication.
Staff did not ensure resident's medication is not contaminated.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Galarza conducted an initial 10-day complaint investigation visit to investigate the allegations above. LPA discussed the purpose of the visit with Med-Tech Supervisor Julia Elias. Administrator Joyce Garcia arrived later.

The investigation consisted of: The interior and exterior physical plant was toured, medication room was inspected and R1's medications were reviewed. Copies of Medication Administration Records August 2025, Appraisal/needs and Services Plan, LIC 500 Personnel Report, and resident roster were reviewed/obtained. Residents (R1-R17) and staff (S1- S5) were interviewed.

*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: 08/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2025

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-20250821153811

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: 08/26/2025

NARRATIVE

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Allegation: Staff are mismanaging resident's medication. The complaint alleges that on August 21, 2025 resident (R1) was only given 5 medication pills instead of the 6 medication pills as ordered by their physician. As a result, it is believed that staff have been "overdosing" R1 by giving the resident 6 pills instead of 5 medication pills. Seventeen (17) residents were interviewed. One (1) out of 17 residents concurred with the allegation, and stated that staff are not giving the resident the same amount of medication pills. Five staff were interviewed, of which all denied the allegation. Staff interviews revealed that R1 has hallucination history regarding medications and complains regularly about medication mismanagement. In order to mitigate R1's concerns, med-tech staff started placing a cover in R1's medication cup so that the resident feels safe when taking the medications. Resident (R1's) medications were audited. LPA reviewed Medication Administration Records (MARs) and audited the medication bubble packs. Per record review, physician orders state that R1 is to take 8 medications every day and 1 PRN medication. The facility implements medication negative charting. No discrepancies were observed. There is not enough evidence to support the allegation.

Allegation: Staff did not ensure resident's medication is not contaminated. According to information obtained resident (R1's) medications had blood on top of them. The incident occurred a long time ago, date is unknown. A total of 17 residents were interviewed. One (1) out of 17 residents confirmed the allegation. The majority of residents said their medications are not contaminated and the medications are given in clean medication cups. All staff denied the allegation. Staff stated that if medications were contaminated they would never be distributed to the residents, and they would have to call the pharmacy for medication replacement. Based on observation in the med-tech room during medication audit, eight (8) routine medications were observed in bubble packs and one (1) PRN medication is in a bottle. Medication cups were sanitary. There was no evidence of mishandling, contamination of medications, or medication storage issues.

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 conducted with Administrator 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: 08/26/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/26/2025

LIC9099 (FAS) - (06/04)

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