198601566-7-8-2021-11-AS-MCAA-C5M22G-20210805170042

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601566
Report Date: 07/08/2021
Date Signed: 07/08/2021 04:30:02 PM

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 DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/07/2021 and conducted by Evaluator Jennifer Jones

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20210707092729

FACILITY NAME:	STUDIO ROYALE		FACILITY NUMBER:	198601566
ADMINISTRATOR:	TERRI WEITZMAN		FACILITY TYPE:	740
ADDRESS:	3975 OVERLAND AVENUE		TELEPHONE:	(310) 836-5854
CITY:	CULVER CITY	STATE: CA	ZIP CODE:	90232
CAPACITY:	175	CENSUS: 80	DATE:	07/08/2021
		UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Terri Weitzman, Executive Director		TIME COMPLETED:	04:40 PM

ALLEGATION(S):

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Resident did not receive her medication on time.
Staff intimidated the resident.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Jennifer Jones and Jade Jordan initiated a complaint investigation and delivered findings for the allegations listed above. During today’s visit, LPAs met with the Executive Director, Terri Weitzman and discussed the allegations.

On 07/08/21, LPAs toured the facility and interviewed resident 1-8 and staff Staff 1-5 about the allegations.

The allegations revealed the following: For allegation: (Resident did not receive her medication on time.) It is being alleged that Resident 1 did not receive her morning medication on time. Staff 1/Executive Director, Terri Weitzman stated that R1 takes her morning medications with breakfast. Staff 1 stated the med tech realized one of R1's medications was missing and advised her that they were going to go look for it. Staff 1 stated that R1 became upset and started yelling at the med tech. Staff 2 stated during her interview that she realized R1's medication was missing when she gave her the other medications and advised R1 that one medication was missing and she was going back to the med room to see where it was. S2 stated that R1

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Michael Cava	TELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Jennifer Jones	TELEPHONE: (323) 518-3833
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2021

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 11-AS-20210707092729

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 DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: STUDIO ROYALE	FACILITY NUMBER: 198601566
	VISIT DATE: 07/08/2021

NARRATIVE

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became very upset and started yelling at her and asking where was her medication. S2 stated that she told R1 that it could be a mistake made with the pharmacy and that she was going to check and see what happen. Staff 3 revealed during her interview that staff 2 told her that R1's medication was missing. Staff 2 and Staff 3 stated that the pharmacy made an error in the bubble packaging and R1's medication was missing for that morning. Staff 2 and 3 stated that they gave R1 the morning medication that was supposed to be for the next morning until they contacted the pharmacy. Staff 2 and 3 stated that they contacted the pharmacy about the error and the pharmacy provided staff with a letter due to the error and gave additional medication for R1. Staff 2 and 3 stated that R1 received her medication within the same hour. Staff 4 and Staff 5 revealed during their interviews that they do not handle the medications. Staff 4 stated that she observed R1 yelling at staff 3. LPAs interviewed Resident 1 -8. Resident 1 stated that she went down to take her morning meds and staff told her one was missing. R1 stated that staff starting making excuses and she got upset. R1 stated that she received her morning medication a few hours later. R2-R8 stated that they receive their medications on time and did not have an issue with their medications. R7 handles her own medication and doesn't require assistance and R8 does not take medication.

For Allegation:(Staff intimidated the resident.) It is being alleged that staff intimidated R1. LPAs interviewed Staff 1- 5 about the allegation. Staff 1 stated that R1 is rude and yells at staff when she becomes upset. Staff 1-5 stated that R1 calls them names and makes a lot of complaints. R1 revealed during her interview that staff 3 is intimidating. LPA asked how is she intimidating and R1 stated that S3's clothing and hair is intimidating. R1 stated that S3's demeanor is intimidating. Residents 2-8 revealed during their interviews that they like living in the facility and staff are nice. Residents 2-8 stated that they do not have any concerns with staff. Resident 2-8 stated that they have not experienced staff being rude to them.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.

A copy of the report was giving to Executive Director, Terri Weitzman,

SUPERVISOR'S NAME: Michael Cava	TELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Jennifer Jones	TELEPHONE: (323) 518-3833
LICENSING EVALUATOR SIGNATURE:	DATE: 07/08/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2021

LIC9099 (FAS) - (06/04)

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