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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 03/09/2022
Date Signed: 03/09/2022 04:08:32 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
03/02/2022 and conducted by Evaluator Jose Villalobos
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20220302093842
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:
03/09/2022
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Administrator Yitzi Teichman TIME COMPLETED:
01:00 PM
ALLEGATION(S):
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9
Resident received opened mail
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jose VIllalobos conducted an unannounced complaint visit regarding the above allegation. LPA met with Administratror Yitzi Teichman and explained the reason for the visit.

The investigation consisted of the following: LPA obtained a client and staff roster and interviewed Staff #1 – #6 (S1 – S6), and Client #1-#12 (C1 – C12).

The investigation revealed the following: In regards to the allegation "Resident received opened mail", it was alleged that staff opened C1's mail before handing it to C1 on 3/1/22. (6) of (6) Staff interviewed denied the allegation. (11) of (12) clients interviewed could not corrborate the allegation. Interviews show that client mail is held in the facilities medication room. Staff will inform clients via speaker system that they have mail or will also hand out the mail to clients as they come for their medications. Interviews did not show that staff open any clients mail. On 3/1/22, C1 received an envelope that was not sealed properly. Staff S2 and S3 received the mail and handed it to C1 but it was not opened by any staff.

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: 03/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022
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-20220302093842
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: 03/09/2022
NARRATIVE
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LPA observed the alleged envelope C1 provided but did not appear to show any signs that the seals were opened. There were no witnesses that would prove staff open client mail. Based on the interviews conducted and observations, there was not enough supportive evidence to concur with the reported allegation. 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 was conducted with Administrator Yitzi Teichman and a copy of this report was provided.
NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Jose Villalobos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2