198601591-4-11-2022-11-AS-AJKK-CDQVPD-20220422163634

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601591
Report Date: 04/11/2022
Date Signed: 04/11/2022 04:30:57 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 DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/07/2022 and conducted by Evaluator Troy Agard

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20220407103216

FACILITY NAME:	BENTLEY HOUSE		FACILITY NUMBER:	198601591
ADMINISTRATOR:	BIOSEH OGBECHIE		FACILITY TYPE:	740
ADDRESS:	3449 ROSEWOOD AVE		TELEPHONE:	(213) 478-0800
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90066
CAPACITY:	6	CENSUS: 4	DATE:	04/11/2022
		UNANNOUNCED	TIME BEGAN:	10:27 AM
MET WITH:	Lilybelle “Jey” Calzado, Lead Caregiver		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Illegal eviction
Staff failed to provide activities for residents in care
Staff is not following the admission agreemnt for transportation

INVESTIGATION FINDINGS:

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On 04/11/2022 Licensing Program Analyst (LPA) Troy Agard conducted an initial complaint investigation at the above facility to address the following allegations. LPA Agard was met with Lilybelle “Jey” Calzado, Lead Caregiver and explained the purpose of the visit was to gather information regarding this complaint.

The investigation consisted of the following: LPA conducted an inspection, toured the facility, and conducted interviews. LPA requested the following records: Staff and resident roster, admission agreement for R1, eviction notice for R1, activities calendar, and physicians report

On 04/11/2022, LPA Agard delivered findings.

Continued on 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 981-3347
LICENSING EVALUATOR NAME: Troy Agard	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2022

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-20220407103216

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: BENTLEY HOUSE	FACILITY NUMBER: 198601591
	VISIT DATE: 04/11/2022

NARRATIVE

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Regarding the allegation: Illegal eviction. It’s being alleged the facility is trying to evict a resident for the last two months. “Last week the facility gave a 30-day eviction notice requesting resident to leave the facility by 05/01/2022.”
The investigation revealed the following: 2 of 2 denied the allegation, citing that the eviction is not illegal due to non- payment and the notification sent to Department of Social Services (DSS). S1 states, “yes, R1 hasn’t paid for 3 months, plus this month. When R1 first came here it was paid by University of California, Los Angeles (UCLA). After they stopped paying, R1 didn’t pay anything.” S2 states, “our eviction letter is about nonpayment. We notified DSS, then we served with the letter. R1 has been living with us and not paying. R1 hasn’t paid in 3 months going on 4. We are helping in finding new placement. UCLA stop paying because it was just a letter of agreement (LOA), that the resident would stay for a few months while we both looked for a place for R1 to live. UCLA found R1 a place and unfortunately, they did not want to stay there.” During an interview with W1 they state, R1 doesn’t want to spend their own money, R1 rather pay for multiple storage units than to pay for their own housing.” During an interview with R1 they state, “UCLA placed me here and was paying for my housing, but I don’t know why they stopped. I don’t know who was supposed to resume paying. R1 confirms receiving benefits but states the funds are allocated to personal expenses. R1 states, they generally do not have money to pay the facility. LPA was unable to interview resident R2-4 due to cognitive abilities. R5 was unavailable for interview.

Regarding the allegation: Staff failed to provide activities for residents in care. It’s being alleged staff do not provide any activities for the residents in care and the resident stay in their beds. The RP stated that the room doesn’t have a T.V and only has a radio. The investigation revealed the following: 2 of 2 denied the allegation. S1 states, “yes, we do but R1 doesn’t want to participate. We do coloring, shooting balls, puzzles, bingo, exercise. The current residents are limited in the things they can do. Every Sunday, R1 likes to watch movies outside here in the living room but doesn’t want to sit with the group.” S2 states, “that is incorrect. We have activities every day. R1 doesn’t want to come out of the room. Every time S1 invites R1 they don’t want to come.” R1 states, “they have no social activities here. The only interaction I have is with the caregivers asking me what I want to eat for breakfast lunch and dinner. The night caregiver and I watch 60 minutes and the Equalizer every Sunday. Other activities are not offered, and I wouldn’t participate anyway because it’s just not my thing. I read a lot and write a lot and the thing is I like people, but all these residents are bed bound and don’t really speak. I’m the only one that talks.” LPA was unable to interview resident R2-4 due to cognitive abilities. R5 was unavailable for interview.

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 981-3347
LICENSING EVALUATOR NAME: Troy Agard	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2022

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20220407103216

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: BENTLEY HOUSE	FACILITY NUMBER: 198601591
	VISIT DATE: 04/11/2022

NARRATIVE

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Regarding the allegation: Staff is not following the admission agreement for transportation. It’s being alleged, “the facility is not providing transportation and according to the admission agreement the facility would give transportation to medical appointments. The investigation revealed the following: 2 of 2 denied the allegation. S1 states, “we do provide transportation. In one week, we have to drop R1 off and pick R1 up twice per week, every two weeks plus other appointments. R1 is not paying for parking or the transportation. R1 has not been paying for services.” S2 states in general, they agreed to take R1 to their medical appointment but requests to be driven other places began to increase. When R1 was reminded that transportation was at an additional cost they were met with the inability to be compensated. R1 states, although being in receipt of funds on a monthly basis they are unable to allocate funds to pay for transportation. R1 states, they do not remember seeing in their admissions agreement the cost associated with transportation. LPA was unable to interview resident R2-4 due to cognitive abilities. R5 was unavailable for interview.

During a record review, LPA noted a 30-day eviction notice was received by the Regional Office on March 29^th at 1:03pm. During a record review, LPA observed an activities calendar posted in the facility with activities. During a review of admissions agreement, LPA observed on page 11 of admissions agreement initials of R1 for the cost associated with transportation. R1 confirmed receiving a copy of the signed admission agreement. LPA did observe just a radio in R1’s room but access to a TV in the living room.

Based on LPA’s observation, interviews conducted, and record review, the preponderance of evidence standard has not been met. 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 unsubstantiated.

An exit interview was conducted, and a copy of the report was given

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 981-3347
LICENSING EVALUATOR NAME: Troy Agard	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 04/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2022

LIC9099 (FAS) - (06/04)

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