198601591-6-6-2022-11-AS-UCOL-CGSVAN-20220729161611

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601591
Report Date: 06/06/2022
Date Signed: 06/06/2022 03:54:44 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
MONTERY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/02/2022 and conducted by Evaluator Jey Cardenas

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20220602092853

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: 6	DATE:	06/06/2022
		UNANNOUNCED	TIME BEGAN:	10:12 AM
MET WITH:	Lilibeth Calzado		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Resident is not being provided quality food while in care.
Facility is not adhering to verbal agreement entered into with resident in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jey Cardenas conducted an initial 10- day complaint visit to the above facility to investigate allegations listed above. Upon arrival at the facility LPA meet with Lead caregiver, Lilibelle Calzado. LPA explained the reason for today’s visit and conducted a Covid-19 risk assessment, based on the assessment facility is clear of covid-19 infection.

The investigation consisted of following: LPA Cardenas interviewed Administrator, Mona Alcaraz via telephone, Staff#1-Staff#2 (S1-S2) and Residente#1 – Resident#3 (R1-R3), Resident#4-Resident#6 (R4-R6). were asleep. Per S1; R3-R6 have dementia. LPA obtained the following: Resident Roster, Staff Schedule, Food Menu, Resident Appraisal, Physician’s Report, Admission Agreement, LPA toured plant.

Complaint received is alleging that the food quality is not good. Facility is serving mostly carbs, and food is not nutrition. In addition, administrator, Mona Alcaraz verbally told resident that all transportation would be covered by facility and at no cost.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Jey Cardenas	TELEPHONE: (323) 383-8188
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2022

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-20220602092853

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
MONTERY PARK, CA 91754

FACILITY NAME: BENTLEY HOUSE	FACILITY NUMBER: 198601591
	VISIT DATE: 06/06/2022

NARRATIVE

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Regarding allegation- Facility is not adhering to verbal agreement entered into with resident in care. On 6/6/2022 LPA Cardenas interviewed administrator Mona Alcaraz who indicates that during admission to facility, the cost associated with transportation was covered with R1. R1 was admitted to facility from UCLA, who was paying R1s month service rate for approximately three (3) months (Aug21 -Oct21). During this time Mona temporarily accommodated R1 with transportation to and from medical appointments at no cost. However, from Nov21 to present UCLA stopped paying residents monthly service rate and facility has not received any payment from R1. Facility was shouldering the costs of transportation until the beginning of year' 2022. Facility is unable to continue covering the cost for these services. Mona states she assisted R1 to sign up for access transportation services. R1 currently has access and schedules transportation for pick up and drop. During interview with S1-S2; staff indicate that with the exception of R1 none of the other residents have concerns with transportation to medical appointments. During interview with R1, resident was told by Mona that transportation would be provided at no cost. However, recently facility has requested payment for transportation. R1 states access is not reliable. Access does other pickups and resident has been late to medical appointments. R2 and R3 indicated that at this time they have no concerns with transportation to medical appointments. R4-R6 were asleep at time of visit. During a record review LPA observed admissions agreement pg 11 covers the cost associated with transportation; which is initialed by R1. R1 confirmed receiving a copy of the signed admission agreement but denies facility explaining transportation cost.

Regarding allegation – Resident is not being provided quality food while in care. On 6/6/2022 LPA Cardenas interviewed Mona who indicates that most residents have regular diets, with the exception of one resident who has puree diet. R1 has complained that staff doesn’t know how to cook and refuses to eat at times. The facility would accommodate R1 by purchasing take out such as Panda and BBQ at no cost. S1-S2 indicate that residents are provided with three nutritious meals a day with snack. Everyday S1 asks R1 what would resident like to eat and takes requests. The food menu is available, but at time modified to accommodate residents preferences. S1 states she is not a professional gourmet cook, but is capable of cooking meals for residents. During interview with R1, resident indicates that the food quantity is there however the quality is not good. For example, staff made pancakes and they were not fluffy. Also, staff made toast and left in the oven too long and bread was hard, doesn’t remember if bread was replaced. During interview with R2-R3 residents didn’t have concerns regarding the food, R2 states food is delicious. LPA observed food supply and determined there is ample perishable and non-perishable food available. The menu has a variety of nutritious food selections. Per record review: preplacement appraisal, Care plan, and physician report R1 has normal diet. Based on LPA’s interviews and record reviews, LPA did not find sufficient evidence to support the allegations, Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegations are UNSUBSTANTIATED.

An exit interview was conducted. A copy of the report to be provided to facility representative.

SUPERVISOR'S NAME: Angela J Kendrick	TELEPHONE: (323) 629-7815
LICENSING EVALUATOR NAME: Jey Cardenas	TELEPHONE: (323) 383-8188
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2022

LIC9099 (FAS) - (06/04)

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