198600539-10-13-2021-28-AS-FFIS-CDTTCG-20220425143642

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 10/13/2021
Date Signed: 10/13/2021 04:23:43 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
10/07/2021 and conducted by Evaluator Jose Villalobos

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20211007163428

FACILITY NAME:	PICO RIVERA GARDENS		FACILITY NUMBER:	198600539
ADMINISTRATOR:	MEIR SHAUL YITZI TEICHMAN		FACILITY TYPE:	735
ADDRESS:	6525 ROSEMEAD BLVD.		TELEPHONE:	(562) 949-8489
CITY:	PICO RIVERA	STATE: CA	ZIP CODE:	90660
CAPACITY:	185	CENSUS: 172	DATE:	10/13/2021
		UNANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Supervisor Julia Elias		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Staff speak inappropriately to resident.
Staff withhold P&I funds from residents.
Resident is forced to take medications.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jose Villalobos conducted an unannounced complaint visit regarding the above allegations. LPA met with Supervisor Julia Elias and explained the reason for the visit.

The investigation consisted of the following: LPA obtained copies of Staff & Client Rosters. LPA also toured the facility. LPA also interviewed Clients #1 - Client #8 (C1-C8) and Staff #1 - Staff #5 (S1-S5).

The investigation revealed the following: in regards to the allegation "Staff speak inappropriately to resident." it was alleged that S1 talks down and berates C1 and staff in general treat C2 inappropiatley. (5) of (5) staff interviewed denied the allegation. (7) of (8) clients interviewed could not corrborate the allegation. Interviews do not show that staff speak inappropiately to the clients in care. Interview with C2 stated that staff have never spoken to C2 inappropiately.

Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Jose Villalobos
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2021

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-20211007163428

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: 10/13/2021

NARRATIVE

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LPA did not observe staff speaking inappropriately to clients in care. There were no specific dates or times provided to LPA of when S1 talked down to C1. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

In regards to allegation "Staff withhold P&I funds from residents." it was alleged that the facility staff withheld money from C2. (5) of (5) staff interviewed denied the allegation. (7) of (8) clients interviewed could not corroborate the allegation. Interviews show that C2 was admitted to the facility on 9/7/21. C2's placement agency handled C2's rent payment and P&I funds for that month and the facility did not start receiving the P&I funds from the placement agency until the following month of October. LPA Villalobos observed C2s record of cash resources and confirmed. C2 stated to LPA that they have not had any issues with money at the facility. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

In regards to the allegation " Resident is forced to take medications." it was alleged that S1 does not allow C1 to refuse their medication. (5) of (5) staff interviewed denied the allegation. (8) of (8) clients interviewed could not corroborate the allegation. Interviews show that staff are aware that if a clients refuses their medication, they cannot be forced to take them. Interviews also showed that clients walk up to the med room to grab and take their medication. Staff monitor clients to make sure they take their meds and not walk away with them in order to properly note who does and who doesn't take their meds. C1 does not have a problem taking medication but gets upset staff watch clients to make sure they finish their meds and not walk away with them. LPA reviewed C1's file and it shows C1 did refuse taking medication on 9/26/21 and the staff logged it. LPA was not able to obtain evidence that staff do not allow clients to refuse medication. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit Interview conducted and a copy of this report was provided to Julia Elias.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Jose Villalobos
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2021

LIC9099 (FAS) - (06/04)

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