198601566-11-30-2023-11-AS-MVAO-CZEURD-20240112144829

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601566
Report Date: 11/30/2023
Date Signed: 11/30/2023 07:55:36 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 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
11/28/2023 and conducted by Evaluator Ernand Dabuet

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20231128151552

FACILITY NAME:	STUDIO ROYALE		FACILITY NUMBER:	198601566
ADMINISTRATOR:	LEWIS,ERNEST D.		FACILITY TYPE:	740
ADDRESS:	3975 OVERLAND AVENUE		TELEPHONE:	(310) 836-5854
CITY:	CULVER CITY	STATE: CA	ZIP CODE:	90232
CAPACITY:	175	CENSUS: 89	DATE:	11/30/2023
		UNANNOUNCED	TIME BEGAN:	09:44 AM
MET WITH:	Rhonda Madrid		TIME COMPLETED:	04:01 PM

ALLEGATION(S):

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Licensee does not ensure faucets for personal care deliver adequate water for residents.
Staff do not provide adequate food service to residents.

INVESTIGATION FINDINGS:

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On 11/30/23, Licensing Program Analyst (LPA) Ernand Dabuet conducted a complaint visit at this facility. LPA was greeted by the Marketing Director Rhonda Madrid. This inspection visit is to gather information for the allegation mentioned above and deliver findings.

The investigation consisted of the following: A review of the facility's roster for residents and staff. Interviews with residents #1-#10 (R1-R10), staff #1-#4. A review of faciilty menu, service reports and other pertinent records associated with this complaint was conducted. A tour of the facility was performed.

(Evaluation Report continues LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ernand Dabuet	TELEPHONE: (323) 629-5526
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2023

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 11-AS-20231128151552

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: STUDIO ROYALE	FACILITY NUMBER: 198601566
	VISIT DATE: 11/30/2023

NARRATIVE

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INVESTIGATION REVEALED THE FOLLOWING:

Allegation #1: Licensee does not ensure faucets for personal care deliver adequate water for residents.

It is alleged the facility does not produce consistent water pressure or hot water for hand washing. The complainant reported the public restrooms do not have consistent pressure or hot water for hand washing. The complainant stated this is for the common restrooms often used by visitors or residents did not produce adequate water pressure or hot water temperature for personal care use. The complainant did not provide further details on the time or date of the incident.

On 11/30/23 between 10:30 am and 10:40 am, the Department inspected all (4) public restrooms. The Department observed the public bathrooms were operational with hot water temperature measured at 107.4 - 109.9 degrees F. The public bathrooms had the normal water pressure between 45-80 psi. The restrooms were found to be within Title 22 regulations and were clean and operational.

On 11/30/23 between 11:30 am and 12:45 pm (9) out of (9) residents had no issues with water pressure or hot water temperature when using private or public restrooms. Between 10:00 am - 10:50 am, staff #1 -#2 (S1-S2) confirmed that on 11/16/23 through 1/18/23, the facility's water was shut off due to leaky pipes in rooms #150 and #204. According to (S1-S2) the residents were given 24-hour written advance notice and announcement reminders through intercoms for the temporary shut-off maintenance repairs. (S1-S2) stated the work was done within 2 business days, and it was only 1.5 each day when the water was not operational. Based on the information gathered, the allegation mentioned above cannot be supported.

Allegation #2: Staff do not provide adequate food service to residents.

The details of the complaint alleged the food provided to residents was not served at a proper temperature. The complainant reported the food served is good, but fails to meet satisfactory temperature. The complainant did not provided further details regarding this matter.

(Evaluation Report LIC 9099-C)

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ernand Dabuet	TELEPHONE: (323) 629-5526
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2023

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20231128151552

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

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

FACILITY NAME: STUDIO ROYALE	FACILITY NUMBER: 198601566
	VISIT DATE: 11/30/2023

NARRATIVE

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The Department conducted an assessment between 11:45 and 12:45 pm and observed how meals were prepared and how meals were served. The Department noticed several hot food tray warmers, and food
was carried out within two to three minutes at tables by (5) servers. The meals are “made to order" customized to specifications from the standard daily menu, weekly menu, or alternative menu.

Interviews conducted with staff # 1 and #3 between 10 am and 11:20 am stated that residents have choices aside from what is on the daily/weekly menu and will be made upon request daily. In addition, residents have the right to refuse if they are not satisfied with the temperature; the dish will then be reheated/refrigerated or a new dish will be created. (S1-and S3) stated there is always an option for residents to refuse their meals and replace their meals to their liking if unsatisfied with what is being served. (According to S3), a resident may get preoccupied with socializing while their meals are being served, causing the food to cool for a few minutes.

On 11/30/23, interviews between 11:30 and 12:45 pm (9) out of (9) residents #1-#9 (R1-R9) verified that they were aware of meal options and are aware that they do have the right to refuse meals served are substandard or not served in the proper temperature. (R1-R1) were complimentary of the food and service and had no issues with meals provided by the facility. The facility has a suggestion box available adjacent to the front office and dining room area to garner opinions or suggestions from residents, staff, or visitors. Based on information gathered, there is insufficient evidence to support allegation.

Based on information gathered, through an inspection of the facility, observation, analysis records of service records, interviews, the Department found no evidence to support the allegations: "Licensee does not ensure faucets for personal care deliver adequate water for residents" and "Staff do not provide adequate food service to residents".

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

An exit interview was conducted with Zoila Marroquin, and a copy of this report is provided.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ernand Dabuet	TELEPHONE: (323) 629-5526
LICENSING EVALUATOR SIGNATURE:	DATE: 11/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/30/2023

LIC9099 (FAS) - (06/04)

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