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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 02/16/2022
Date Signed: 02/16/2022 12:50:35 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
02/08/2022 and conducted by Evaluator Angelica Rea
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20220208090129
FACILITY NAME:PICO RIVERA GARDENSFACILITY NUMBER:
198600539
ADMINISTRATOR:MEIR SHAUL YITZI TEICHMANFACILITY TYPE:
735
ADDRESS:6525 ROSEMEAD BLVD.TELEPHONE:
(562) 949-8489
CITY:PICO RIVERASTATE: CAZIP CODE:
90660
CAPACITY:185CENSUS: 170DATE:
02/16/2022
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Yitzi Teichman TIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Staff are not controlling drug usage in the facility, among residents.
Staff are not controlling cigarette usage in the facility among residents.
Staff do not treat the resident with dignity.
Staff are not providing adequate supervision.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Angelica Rea and Jewel Baptiste conducted an unannounced complaint visit in response to the above allegations. LPAs met with Administrator, Yitzi Teichman who assisted with today's visit.

Regarding the allegation that staff are not controlling drug usage in the facility, among residents. The investigation consisted of interviews with Administrator and Staff #1- Staff #3, and Resident #1- Resident #10. Administrator, and staff interviewed denied that they are not controlling drug usage in the facility. They stated that they do not tolerate drug use at the facility. Administrator stated that if they observe resident drug use, the resident will receive an eviction notice. 8 out of 10 residents stated that they have not observed drug use at the facility. Regarding the allegation that staff are not controlling cigarette usage in the facility among residents. The investigation consisted of interviews with Administrator, and Staff #1- Staff #3, and Resident #1- Resident #10. Administrator and staff interviewed denied that they are not controlling cigarette usage inside the facility. They stated that if they observe any residents smoking inside the facility, they tell them to smoke in the smoking area outside. 8 out of 10 residents stated that they have not observed any residents smoking inside the facility.
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Angelica Rea
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2022
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-20220208090129
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: 02/16/2022
NARRATIVE
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Regarding the allegation that staff do not treat the resident with dignity, and staff are not providing adequate supervision. The investigation consisted of interviews with Administrator and Staff #1- Staff #3, and Resident #1- Resident #10. Administrator, and staff interviewed denied that staff do not treat the residents with dignity.
They stated that they have never observed any staff mistreating any of the residents. Administrator, and staff interviewed stated that staff do provide adequate supervision. 9 out of 10 residents stated that staff do treat the residents with dignity. They stated that they have not observed staff mistreat any residents. 9 out of 10 residents stated that staff are providing adequate supervision.

Based on LPA's observations and interviews, investigation revealed: 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.

No Deficiencies cited under California Code of Regulations Title 22. Exit interview conducted, and a copy of report was provided to Administrator, Yitzi Teichman.
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Angelica Rea
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2