198601542-4-18-2024-11-AS-SCIS-D9GQ92-20240926115736

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601542
Report Date: 04/18/2024
Date Signed: 04/18/2024 03:52:12 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/17/2024 and conducted by Evaluator Elvira Gonzalez

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20240417132959

FACILITY NAME:	WILKIE HOME		FACILITY NUMBER:	198601542
ADMINISTRATOR:	MARGARITA NUNEZ RENTERIA		FACILITY TYPE:	735
ADDRESS:	17234 WILKIE AVE		TELEPHONE:	(310) 538-8599
CITY:	TORRANCE	STATE: CA	ZIP CODE:	90504
CAPACITY:	3	CENSUS: 3	DATE:	04/18/2024
		UNANNOUNCED	TIME BEGAN:	09:08 AM
MET WITH:	Yanett Aguilar		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Facility staff refused to give client medication.
Staff is not trained in medication administration.

INVESTIGATION FINDINGS:

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On 04/18/24 Licensing Program Analyst (LPA) Elvira Gonzalez conducted an unannounced complaint visit to this facility. LPA met with Yanett Aguilar and explained the purpose of today’s visit.

The investigation consisted of the following: LPA interviewed staff #1-#2 (S1-S2) and interviewed client #1 (C1) and attempted to interview clients #2 and #3 (C2-C3). A review of C1’s Medications orders, Physician’s Report, Individual Restricted Health Condition Care Plans, Medication Administration Records (MAR) for the months of March 2024 and April 2024. LPA reviewed and received: Client Roster, Employee Roster, staff schedule for 03/10/24 through 03/16/24, and other pertinent documents associated with this complaint.

Continued on LIC 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

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 4

Control Number 11-AS-20240417132959

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: WILKIE HOME	FACILITY NUMBER: 198601542
	VISIT DATE: 04/18/2024

NARRATIVE

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The investigation revealed the following: Regarding the allegation: Facility staff refused to give client medication. It is alleged that on 03/16/24, the client woke up in the middle of the night and was having an asthma attack and needed their PRN medication. When the client asked staff for their medication staff said they were not qualified to give them their medication and that client would have to wait for the morning shift to get their medication.

On 04/18/24 LPA interviewed Administrator Yanett Aguilar; she stated that the facility had been short on staff around the time of this incident. Staff from the day program associated with the facility had been assisting with shifts at this facility. The Administrator also stated that those staff members helping were not trained to pass out medication to clients. She stated that none of the staff that worked overnight the week of 03/10/24 – 03/16/24 mentioned anything about the above incident, or about any medication denied to a client or clients. Administrator Yanett Aguilar also stated that if a client did ask for medication at night during the dates of 03/10/24 – 03/16/24, the staff working those shifts were not trained to administer medication to clients and more than likely would not have given the medication to the client.

Between 1:30 PM – 2:00 PM LPA Gonzalez attempted to interview 2 staff members that worked the night shift on the week of 03/10/24 – 03/16/24 who did not return the calls.

Based on evidence gathered, interviews conducted, records reviewed, the preponderance of evidence standard has been met; therefore, the allegation of “Facility staff refused to give client medication” is found to be SUBSTANTIATED.

Continued in LIC 9099-C.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20240417132959

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: WILKIE HOME	FACILITY NUMBER: 198601542
	VISIT DATE: 04/18/2024

NARRATIVE

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Regarding the allegation: Staff is not trained in medication administration. It is alleged that on 03/16/24 the client asked night staff for their PRN medication. Staff said they were unqualified to do that, and that the client would have to wait for morning shift staff or 911 could be called. An interview conducted with Administrator Yanett Aguilar revealed that on the dates of 03/10/24 – 03/16/24 the staff working the night shift were not trained to administer medication and would not be able to administer medication to a client if needed. Interviews conducted with S1-S2 communicated that staff are now currently trained in medication administration and policies, and that they are training any new and incoming staff as they come in medication administration. Both S1 and S2 stated that staff are now currently trained in medication administration and policies. An interview conducted with C1 communicated that on the night of 03/11/24 or 03/12/24 and not the night of 03/16/24 staff told C1 that they were unable to give client their medication because they were not trained on medication administration, and they were not qualified to do so. C1 stated that staff told them that they had two choices: one they can wait until the AM shift arrived to get their medication or two, staff can call 911 and client can then go to the hospital. Client chose to sit up in bed and calm themselves down until AM staff arrived.

Based on evidence gathered, interviews conducted, records reviewed, the preponderance of evidence standard has been met; therefore, the allegation of: Staff is not trained in medication administration” is found to be SUBSTANTIATED.

According to the California Code of Regulations (Title 22, Division 6, Chapter 8), the following deficiencies have been observed and a citation issued (ref. LIC 9099D).

An exit interview was conducted and a copy of the report along with Appeal Rights was provided to Administrator Yanett Aguilar.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20240417132959

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: WILKIE HOME	FACILITY NUMBER: 198601542
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/18/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 04/26/2024 Section Cited CCR 80075(b)	1 2 3 4 5 6 7	80075 Health Related Services (b) Clients shall be assisted as needed with self-administration of prescription and nonprescription medications. This requirement is not met as evidenced by: Based on interviews, and records reviewed, C1 was denied their PRN medication and staff said they were not trained to administer medication. Administrator was aware and agreed that the night staff working the nights of 03/10/24 and 03/16/24 were not trained to administer medication. This violation possesses an immediate Health and Safety risk to residents in care.	1 2 3 4 5 6 7	The Licensee shall ensure that all medications are administered to all the clients as prescribed. The licensee will conduct medication training by a pharmacy or another health care professional. A plan of correction shall be submitted by POC 04/26/24 and send to Elvira.gonzalez@dss.ca.gov
Type B 04/26/2024 Section Cited CCR 80065(f)(4)	1 2 3 4 5 6 7	80065 Personnel Requirements (f) All personnel shall be given on-the-job training or shall have related experience which provides knowledge of and skill in the following areas, as appropriate to the job assigned and as evidenced by safe and effective job performance. (4) Assistance with prescribed medications which are self-administered.	1 2 3 4 5 6 7	The licensee will conduct medication training by a pharmacy or another health care professional. A plan of correction shall be submitted by POC 04/23/24 and send to Elvira.gonzalez@dss.ca.gov
	8 9 10 11 12 13 14	This requirement is not met as evidenced by: Based on interviews, and records reviewed, C1 was denied their PRN medication and staff said they were not trained to administer medication. Administrator was aware and agreed that the night staff working the nights of 03/10/24 and 03/16/24 were not trained to administer medication. This violation possesses an immediate Health and Safety risk to residents in care.	8 9 10 11 12 13 14
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Elvira Gonzalez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

LIC9099 (FAS) - (06/04)

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