198601716-12-4-2023-28-AS-TVAO-CZCL3G-20240110072349

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601716
Report Date: 12/04/2023
Date Signed: 12/04/2023 01:34:04 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/17/2022 and conducted by Evaluator Elizabeth Irra

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20220217100604

FACILITY NAME:	CHOICES R US - MIGUEL		FACILITY NUMBER:	198601716
ADMINISTRATOR:	CARDENAS, GILBERT		FACILITY TYPE:	735
ADDRESS:	3951 MIGUEL AVE		TELEPHONE:	(562) 801-3061
CITY:	PICO RIVERA	STATE: CA	ZIP CODE:	90660
CAPACITY:	4	CENSUS: 4	DATE:	12/04/2023
		UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Raquel Gama/Assistant Administrator		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Personal Rights/Medical treatment for resident was not sought in a timely manner.
Personal Rights/Resident was forced to go on a walk while in care.
Personal Rights/Resident's medical records were being falsified by staff.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Elizabeth Irra conducted a subsequent visit to investigate the above allegations. LPA met with Raquel Gama and discussed the purpose of today's visit.

LPA Irra conducted the initial visit on 02/17/2022. During this visit, LPA conducted a tour of the building and grounds and did not observe any signs of neglect, abuse or other immediate health and safety threats. During this visit, LPA reviewed Client #1 (C-1) file and obtained relevant documentation. Additionally, LPA obtained a copy of the staff roster with contact telephone numbers and a client roster.

During this investigation, LPA also interviewed Client #2 (C-2) through Client #5 (C-5), Staff #1 (S-1), Staff #2 (S-2) and Staff #4 (S-4). Staff #3 (S-3) is no longer working at this facility. LPA also called C-1 previous Service Coordinator from the placement agency and left a message for a return call.

Refer to LIC 9099C for the continuation of this report.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2023

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 28-AS-20220217100604

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: CHOICES R US - MIGUEL	FACILITY NUMBER: 198601716
	VISIT DATE: 12/04/2023

NARRATIVE

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Personal Rights/Medical treatment for resident was not sought in a timely manner. It is alleged that on 02/15/22, C-1 was not feeling well and that C-1’s temperature (alleged temperature was “102 degrees”) was taken and was observed to be lethargic and coughing. LPA obtained and reviewed C-1’s temperature log for the months of January 2022 and February 2022. LPA also obtained C-1’s Medication Administration Record (MAR) for the months of January 2022 and February 2022. Per C-1’s temperature log, on 02/15/22, C-1’s temperature was documented to be 97.6 degrees. Per C-1’s (MAR), on 02/15/22, C-1 was provided with Promethazine DM (cough medicine-to be administered as needed) at 2PM and 10PM with result noted stating “feels better” after an hour of being administered. C-1 received a last dose of Promethazine DM on 02/16/22 at 8AM with result notes stating “feels better” after an hour of being administered. Per C-1’s file review, there was no indication that C-1 required additional medical treatment. Interviewed clients and staff indicated that staff seek medical treatment for clients on a timely manner. Reviewed documentation and interviews conducted do not corroborate this allegation.

Personal Rights/Resident was forced to go on a walk while in care. It is alleged that on 02/16/22, S-2 gathered the clients and prepared them for a walk outside and that C-1 complained and did not want to go out for a walk as C-1 was allegedly not feeling well. It is alleged that C-1 was forced to go out for a walk. (3) out of the (4) interviewed clients indicated that C-1 wanted to go out for a walk and was not forced. Per client interviews, C-1 and C-3 were the only clients that participated in the community walk. (3) out of (4) interviewed clients indicated that C-1 appeared to be fine on 02/16/22. Interviewed clients indicated that staff do not force anyone to go out for walks. Interviewed staff indicated that staff do not force any clients to go out for walks. Client and staff interviews do not corroborate this allegation.

Personal Rights/Resident's medical records were being falsified by staff. Is it alleged that staff was told to put their initials on C-1’s Medication Administration Record (MAR) as it “was missing initials from previous days”. It was also alleged that “a number of administrators or main office people, that were going in and out the home allegedly cleaning and straightening out records”. Interviewed clients indicated they do not know what is documented on client files. Interviewed staff indicated that staff do not falsify client medical records. Interviews do not corroborate this allegation.

Based on record review and interviews conducted the findings indicate, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegations are UNSUBSTANTIATED.

***An exit interview conducted, appeal rights and a copy of this report was provided to Raquel Gama***

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2023

LIC9099 (FAS) - (06/04)

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