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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198600539
Report Date: 10/20/2022
Date Signed: 10/20/2022 03:55:25 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
10/14/2022 and conducted by Evaluator Jose Villalobos
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20221014131903
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:
10/20/2022
UNANNOUNCEDTIME BEGAN:
10:10 AM
MET WITH:Assistant Administrator Andrew De Vera TIME COMPLETED:
01:30 PM
ALLEGATION(S):
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Client is not afforded comfortable accommodations while in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jose Villalobos conducted an initial complaint visit regarding the allegation above. LPA met with Assistant Administrator Andrew De Vera and the purpose of the visit was dicussed.

On todays visit LPA toured the physical plant including rooms #'s 202 , 203, 204 , 114 , 7 , and 27. LPA reviewed and collected copies of files from Client #1's file. LPA interviewed clients #1-#16 (C1-C16) and staff #1-#5 (S1-S5) during todays visit.

The investigation revealed the following: In regards to the allegation "Client is not afforded comfortable accommodations while in care" it was alleged that the hallways and room have irregular temperatures making things uncomfortable to clients in care. (5) of (5) Staff denied the allegation. (15) of (16) clients interviewed could not corroborate the allegation....

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: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
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-20221014131903
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: 10/20/2022
NARRATIVE
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LPA observed (4) separate thermostats in the hallways reading temperatures of 70 degrees, a temperature within title 22 regulations. Rooms that LPA toured were observed to be between 70-75 degrees. Interviews show that clients are comfortable with the temperature in the hallways and in their rooms. LPA was not provided with evidence that clients were not provided comfortable accommodations in care due to the temperature. Based on interviews and observations, 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 this allegation is unsubstantiated.

Exit Interview was conducted 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: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2