198600581-10-6-2023-28-AS-RORN-D2NN2C-20240221090427

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198600581
Report Date: 10/06/2023
Date Signed: 10/06/2023 05:20:27 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
09/26/2023 and conducted by Evaluator Nicol Wesley

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230926124223

FACILITY NAME:	HOMES FOR LIFE FOUNDATION-HFL CEDAR STREET HOME		FACILITY NUMBER:	198600581
ADMINISTRATOR:	VIDA ANDRADE		FACILITY TYPE:	735
ADDRESS:	11401 BLOOMFIELD, BLDG.305-307		TELEPHONE:	(562) 207-9660
CITY:	NORWALK	STATE: CA	ZIP CODE:	90650
CAPACITY:	38	CENSUS: 27	DATE:	10/06/2023
		UNANNOUNCED	TIME BEGAN:	09:35 AM
MET WITH:	Vida Andrade		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff did not seek medical attention in a timely manner.
Staff did not ensure that resident was provided with prescribed medication.

INVESTIGATION FINDINGS:

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Licensing Program Analyst(LPA) Nicol Wesley conducted an unannounced 10 day compliant visit at the facilty and met with Vida Andrade to discuss the purpose for the visit.

Investigation consisted of: interviews with resident's, interviews with staff, Nurse, review the MAR, resident #1 file.

Regarding allegation: Staff did not seek medical attention in a timely manner. the facility told R1 to go to their doctor(on call doctor) because the facility has their own medical provider and their MOU with Cental City Community Health Center. R1 was a new admit who had been just released from jail and thier primary doctor was located in jail jurisdication. R1 went to see their doctor via zoom because they said it was an emergency, the doctor prescribed a medication and throat spray which was not covered by the insurance. The facilty Nurse asked R1 if they wanted to pay for the throat spray which was not covered and R1 answered no(and signed a paper). 4 out of 5 residents said they receive medical attention in a timely manner.
continued on LIC 9099C.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Nicol Wesley
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2023

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-20230926124223

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: HOMES FOR LIFE FOUNDATION-HFL CEDAR STREET HOME	FACILITY NUMBER: 198600581
	VISIT DATE: 10/06/2023

NARRATIVE

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regarding allegation Staff did not ensure that resident was provided with prescribed medication. Dr. Brent which is the Facility doctor(on call doctor) prescribed some antibiotics and throat spray for R1. The antibiotics where covered through their insurance, but the throat spray was not. The facility Nurse asked R1 if she wanted to pay for the throat spray which was not covered and R1 answered no(and signed a paper). The resident had taken the antibiotics that was prescribed but didn't want to pay for the throat spray which is an over the counter medication. 4 out of 5 residents said the facility makes sure they get their medication.

Based on LPAs observation and interviews, the preponderance of evidence standard has not been met, therefore the above allegations are found to be Unsubstantiated.

A copy of this report was given to the Administrator Vida Andrade.

NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Nicol Wesley
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2023

LIC9099 (FAS) - (06/04)

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