198600574-3-22-2024-11-AS-SCIS-D55VQN-20240510163838

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600574
Report Date: 03/18/2024
Date Signed: 03/22/2024 09:42:13 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/12/2024 and conducted by Evaluator Pamela Bunker

COMPLAINT CONTROL NUMBER: 11-AS-20240312164208

FACILITY NAME:	PARADISE PALACE 1		FACILITY NUMBER:	198600574
ADMINISTRATOR:	CHANDLER, BRENDA		FACILITY TYPE:	735
ADDRESS:	5360 W 119TH PL		TELEPHONE:	(310) 725-9106
CITY:	INGLEWOOD	STATE: CA	ZIP CODE:	90304
CAPACITY:	3	CENSUS: 2	DATE:	03/18/2024
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Shawnda Muckleroy		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Staff verbally abusive to residents.
Staff called residents inappropriate names.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint visit on Monday, March 18, 2024, Upon arrival at the facility. LPA Bunker called the facility via telephone and conducted a Risk Assessment. Based on the assessment, the facility is cleared of COVID-19 infection. LPA Bunker met with Administrator Kim Post. LPA Bunker explained the purpose of today's visit.

The investigation consisted of the following: Interviews were conducted with staff members 1-4 (S1-S4). LPA Bunker was unable to interview residents 1-2 (R1-R2) they are non-verbally. According to the statements from S1-S4, there were no instances of staff verbally or physically abusing any of their residents. S1-S4 stated staff do not hit or yell at residents. Nor does staff call residents inappropriate names. LPA Bunker toured the entire facility to observe and identify any signs of neglect, abuse, or other immediate health and safety threats. We did not observe any signs of neglect or abuse during today's visits. LPA Bunker did not observe any injuries or bruises on R1 and R2. LPA Bunker requested and thoroughly reviewed R1-R2 records and requested copies of supporting documents. See continued LIC9099-C page 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2024

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 3

Control Number 11-AS-20240312164208

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: PARADISE PALACE 1	FACILITY NUMBER: 198600574
	VISIT DATE: 03/18/2024

NARRATIVE

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Continued LIC9099-C page 2

Allegation #1: Staff verbally abusive to residents.
Staff members 1- 4 (S1-S4) have uniformly asserted that there has been no verbal abuse directed toward any residents within the facility. The institution upholds a stringent zero-tolerance policy against any form of abuse, reinforcing its commitment to the welfare and dignity of all individuals under its care. These staff members affirm that residents are safeguarded against any corporal or unusual punishment, and there has been no observation of verbal or physical abuse by any personnel. As mandated reporters, S1-S4 emphasized that any incidents of abuse would be promptly reported in accordance with Title 22 Regulations. Observations of residents 1 and 2 revealed no physical evidence of injury or bruising that could suggest mistreatment. S1-S4 highlighted the facility's comprehensive surveillance system, which serves as an additional safeguard by documenting all interactions and thereby ensuring the safety and security of all residents. The allegations of verbal abuse have been categorically denied by the staff members in question.

Allegation #2: Staff called residents inappropriate names.
Staff 1-4 (S1-S4) deny engaging in the use of inappropriate language towards residents based on the speed of their responsiveness. Staff members affirm that they do not engage in physical aggression, raise their voices, or resort to name-calling in their interactions with residents. They also reported that there have been no incidents of residents grabbing staff members' clothing. S1-S4 refutes the allegations presented against them.

The investigation consisted of the following:
LPA Bunker conducted interviews with staff members S1-S4 (S1-S4). S1-S4 denied any allegations of verbal or physical abuse towards residents, emphasizing the facility's zero-tolerance policy on abuse and commitment to resident welfare and dignity. They assert that no inappropriate language, physical aggression, yelling, or name-calling occurs, and refute claims of residents grabbing staff clothing. S1-S4 stated no one witnessed the allegations presented. There were no specific dates and times related to the purported incidents were provided, rendering verification challenging. The exact date and time in December 2023 was not provided. S1-S4 stated that there were no instances of abuse documented within the facility for the month of December 2023.

See continued LIC9099-C page 2

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20240312164208

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: PARADISE PALACE 1	FACILITY NUMBER: 198600574
	VISIT DATE: 03/18/2024

NARRATIVE

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Continued LIC9099-C page 3

S1-S4 highlights the facility's use of a comprehensive surveillance system to document interactions, ensuring resident safety. Observations of residents 1-2 (R1-R2) showed no signs of mistreatment. S1-S4 stated that the staff is well-trained and competent, equipped to meet residents' daily needs. All allegations have been denied by the staff.

Based on interviews, available evidence, observation, information received, and records reviewed there was not enough sufficient evidence to support the 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 deemed unsubstantiated.

A copy of the Complaint Investigation Report LIC9099 and LIC9099-C was provided to the facility Administrator Kim Post.

There were no deficiencies cited.

An exit interview was conducted.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 03/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2024

LIC9099 (FAS) - (06/04)

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