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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198601778
Report Date: 05/08/2021
Date Signed: 05/10/2021 02:03:38 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 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
05/18/2020 and conducted by Evaluator Cynthia D Chan
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20200518135049
FACILITY NAME:BROOKDALE UPTOWN WHITTIERFACILITY NUMBER:
198601778
ADMINISTRATOR:MAGPAY, PRECIOSA (SUZIE)FACILITY TYPE:
740
ADDRESS:13250 E PHILADELPHIA STTELEPHONE:
(562) 945-3904
CITY:WHITTIERSTATE: CAZIP CODE:
90601
CAPACITY:280CENSUS: 113DATE:
05/08/2021
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Preciosa Magpayo, Administrator TIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Facility is in disrepair.
Facility is unsanitary.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent visit for the allegations listed above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s complaint investigation was conducted telephonically with Preciosa “Suzie” Magpayo, the facility Administrator.

The initial visit was conducted telephonically by LPA Miramontes on 5/28/2020 and requested for the following documents: Resident registry, Personnel Report, (LIC500), facility food menu for the months of April and May 2020, pest control company invoices and reports for the months of March, April and May 2020, in addition to elevator maintenance service invoices for the year of 2020 and invoices for repairs to roof. On 3/18/2021, LPA Chan and Flores conducted a subsequent visit to tour the facility and rooms #106, #119, #210, #223, #303, #325, #401, #428, #439, #441, and #443. On 3/24/21, 6 residents were interviewed. On 3/29/2021, additional 4 residents and 6 staff were interviewed.
(Continue on LIC9099C)
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Cynthia D ChanTELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2021
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 6
Control Number 28-AS-20200518135049
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 CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: BROOKDALE UPTOWN WHITTIER
FACILITY NUMBER: 198601778
VISIT DATE: 05/08/2021
NARRATIVE
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The investigation revealed the following:
Regarding allegation – Facility is in disrepair. It is alleged that there is water leaking from the roof in room #441 on 5/18/2020. It is also alleged that the elevator needs to be replaced as it makes horrible sounds and it broke a couple of times last year. The Administrator admitted that Room #441 had the roof repaired due to leaks which occurred in August 2020. The company came out again in December 2020 to repair the same leak which was still under warranty. The maintenance director also said that room #441 had water leaks in 2020 due to the heavy rain. LPA obtained invoices from the Murray Construction Company verifying the roof repairs. During a virtual visit on 3/18/21, LPAs Chan and Flores observed 4 of the rooms on the 4th floor which appeared to have water stains on the roof. Regarding the elevator, 5 Staff interviewed confirmed that the elevator had been inoperable for a few weeks. In addition, 6 out of 10 residents indicated that the elevator closer to the backdoor was down for weeks, causing an inconvenience for residents. The Administrator stated that the repair has been completed and is waiting for the inspector to ensure that the elevator is safe to use.
Regarding allegation – Facility is unsanitary. It is alleged that trash is not picked up in a timely manner and stays in front of the resident’s room for a long time. Based on the interviews with residents, 7 out of 10 residents indicated that the trash is placed outside of their rooms usually by 7pm. Residents were instructed to tie up their trash bag and put it outside the door for the night staff to pick up. Some stated that they are not sure what time the trash is picked up, while some stated that the trash are picked up after 11pm. Staff interviewed stated that the night shift staff would be the one to collect all the trash bags to throw away at the start of the shift around 10pm.

Based on LPA observation, interviews and documents reviewed, the preponderance of evidence standard has been met, therefore, the above allegations are found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 6 and Chapter 8), are being cited on the attached LIC 9099D.

An exit interview was conducted with the Administrator and a copy of this report was emailed for a signature. The Appeal Rights were also provided.

SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Cynthia D ChanTELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 28-AS-20200518135049
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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: BROOKDALE UPTOWN WHITTIER
FACILITY NUMBER: 198601778
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/08/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/21/2021
Section Cited
CCR
87303(a)
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Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
This requirement is not met as evidenced by:
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The Administrator will ensure that roofs on the 4th floor are in good condition. The Administrator shall submit a statement indicating that the rooms have been inspected to ensure all the roofs are in good condition. This POC is due by 5/21/21.
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Based on LPA observation, interviews, and documents reviewed, the licensee did not ensure that resident roofs on the fourth floor are in good repair at all times which poses a potential health and safety risk to residents in care.
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Type B
05/21/2021
Section Cited
CCR
87303(a)
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Maintenance and Operation (a) The facility shall be clean, safe, sanitary and in good repair at all times. Maintenance shall include provision of maintenance services and procedures for the safety and well-being of residents, employees and visitors.
This requirement is not met as evidenced by:
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The Administrator shall submit proof of the elevator repair completion and in good operating condition by POC due date 5/21/21.
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Based on interviews and documentation, the licensee did not ensure that the elevator is working properly which poses a potential health and safety, or personal rights risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Cynthia D ChanTELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 28-AS-20200518135049
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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: BROOKDALE UPTOWN WHITTIER
FACILITY NUMBER: 198601778
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/08/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/21/2021
Section Cited
CCR
87303(f)(1)
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Maintenance and Operation (f) Solid waste shall be stored and disposed of as follows: (1)Solid waste shall be stored, located and disposed of in a manner that will not permit the transmission of a communicable disease or of odors, create a nuisance, provide a breeding place or food source for insects or rodents.
This requirement is not met as evidenced by:
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The Administrator shall submit a plan to discard trash in a timely manner. This plan shall be submit to LPA by POC due date 5/21/21.
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Based on interviews conducted, the licensee did not ensure that the resident's trash are stored in a manner that will not attract insects or transmit any odor, which poses a health and safety risk to residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Cynthia D ChanTELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 6
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 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
05/18/2020 and conducted by Evaluator Cynthia D Chan
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20200518135049

FACILITY NAME:BROOKDALE UPTOWN WHITTIERFACILITY NUMBER:
198601778
ADMINISTRATOR:MAGPAY, PRECIOSA (SUZIE)FACILITY TYPE:
740
ADDRESS:13250 E PHILADELPHIA STTELEPHONE:
(562) 945-3904
CITY:WHITTIERSTATE: CAZIP CODE:
90601
CAPACITY:280CENSUS: 113DATE:
05/08/2021
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Preciosa Magpayo, Administrator TIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility is infested with roaches.
Facility failed to provide resident adequate food service.
Facility staff failed to return resident's personal belongings.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent visit for the allegations listed above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s complaint investigation was conducted telephonically with Preciosa “Suzie” Magpayo, the facility Administrator.

The initial visit was conducted telephonically by LPA Miramontes on 5/28/2020 and requested for the following documents: Resident registry, Personnel Report, (LIC500), facility food menu for the months of April and May 2020, pest control company invoices and reports for the months of March, April and May 2020, in addition to elevator maintenance service invoices for the year of 2020 and invoices for repairs to roof. On 3/18/2021, LPA Chan and Flores conducted a subsequent visit to tour the facility and rooms #106, #119, #210, #223, #303, #325, #401, #428, #439, #441, and #443. On 3/24/2021, 6 residents were interviewed. On 3/29/2021, additional 4 residents and 6 staff were interviewed.
(Continue on LIC9099C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Cynthia D ChanTELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 28-AS-20200518135049
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 CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: BROOKDALE UPTOWN WHITTIER
FACILITY NUMBER: 198601778
VISIT DATE: 05/08/2021
NARRATIVE
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The investigation revealed the following:
Regarding allegation – Facility is infested with roaches. According to the Ecolab Pest Control service report from February through May 2020, there were no infestation of roaches found. The facility receives monthly services from this pest control company to target pests such as rats and cockroaches. More recently, LPA Chan interviewed the Administrator and 6 Staff in which 2 of them admitted they have seen a few roaches at times but not an infestation of them. The maintenance staff indicated the pest control comes out once a month and will request additional services if needed. LPA also interviewed 10 residents, which 3 of them stated they have seen one or two cockroaches on different occasions. The other 7 residents have not encountered any roaches in their rooms.

Regarding allegation – Facility failed to provide resident adequate food service. It is alleged that the food is always served cold just like it was taken out of the refrigerator. The Administrator stated that due to the Coronavirus pandemic, meals have been delivered to the residents’ rooms for most of 2020. During the visit on 3/18/21, the Administrator stated that the dining room is re-opened, and residents can eat there if they choose. Residents, who want to eat in their rooms, will have their food delivered by the kitchen servers and are given in disposable boxes or saran wrapped. 2 of the 10 residents LPA Chan interviewed had mentioned that their food have been brought to them cold and one stated that the vegetable on the plate was still very cold. One resident cooks own food, while the rest indicated that they are okay with the temperature of the food. They would heat up the food in the microwave or ask for assistance if they want it hotter.

Regarding allegation – Facility staff failed to return resident’s personal belongings. It is alleged that if a resident is not present in the room, the staff would steal the resident’s personal belongings. Based on interviews with the Administrator and Staff, there have not been any confirmed cases of stolen personal belongings. Staff indicated that sometimes residents would report that their belongings are missing or stolen. However, after searching their rooms, it was discovered that the item(s) were misplaced somewhere else in the room. All the residents interviewed stated that the staff do not take their personal belongings.

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.



A telephonic exit interview was conducted with the Administrator. A hard copy was provided via email for a signature along with the Appeal Rights.
SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Cynthia D ChanTELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:

DATE: 05/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2021
LIC9099 (FAS) - (06/04)
Page: 6 of 6