198601778-5-13-2024-28-AS-RORN-D9MQCZ-20241001120358

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601778
Report Date: 05/13/2024
Date Signed: 05/13/2024 03:04:25 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 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
05/07/2024 and conducted by Evaluator Jose Villalobos

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240507112542

FACILITY NAME:	BROOKDALE UPTOWN WHITTIER		FACILITY NUMBER:	198601778
ADMINISTRATOR:	PRECIOSA (SUZIE) MAGPAYO		FACILITY TYPE:	740
ADDRESS:	13250 E PHILADELPHIA ST		TELEPHONE:	(562) 945-3904
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90601
CAPACITY:	280	CENSUS: 105	DATE:	05/13/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Executive Director Suzie Magpayo		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

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Staff does not ensure air quality is safe for residents in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jose Villalobos conducted an initial complaint investigation visit for the allegations listed above. LPA met with Executive Director Suzie Magpayo and the purpose of the visit was discussed.

During todays visit, LPA Villalobos conducted the following: toured the physical plant which included all (4) floors of the facility, common areas, patios, and dining area. The tour also included room #'s 119, 121, 308, 312, 314, 324, 339, 406, 411, 414, and 415. LPA interviewed residents #1-#10 (R1-10) and Staff #1-#6 (S1-S6). LPA also interviewed R1's Nurse Practitioner (NP). LPA collected documents from R1 files which included their physicians report, Care plan and Facesheet. The Investigation revealed the following:

Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981- 3981
LICENSING EVALUATOR NAME: Jose Villalobos	TELEPHONE: (323) 980-4939
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2024

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-20240507112542

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: 05/13/2024

NARRATIVE

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In regards to the allegation "Staff does not ensure air quality is safe for residents in care" it is alleged that
unhealthy air enters R1's room causing them health problems. (5) of (6) Staff interviewed denied the allegation. (9) of (10) Residents interviewed could not corroborate the allegation. Interviews state that R1 has spoken to facility staff regarding toxic air entering their room through the vents multiple times a day causing their skin and eyes to burn. All staff interviewed denied seeing any toxic dust and air entering R1's room but (1) of (6) staff interviewed added that R1's experience could be valid. LPA Villalobos interviewed R1 in their room between 10:30am-11am and did not observe any dust or other particles coming out of R1's vents. LPA did observe that R1 has covered their vents with cardboard and tape except for one vent in the bathroom. LPA was provided a bottle of dust and lint that was alleged to have come out of the vent. It was explained to LPA that is was something more toxic than regular dust. LPA did not observe dust particles to be flowing in the air while in R1's room. All other residents interviewed were not aware of any issues with the air quality of the facility and did not observe any dust flowing out of their vents. LPA did not observe any dust or other particles coming out of any vents from the rooms LPA toured. Interview with NP states that R1 has a medical condition that has been going on for years regarding their eye health. R1's eye health has been in decline for years and occasionally causes pain and discomfort. NP did not suggest any correlation between R1's eye health and any issues with the air quality of the facility. File review does not show that there is any medical record of R1 having burns or negative experience from the air quality in the facility. Based on interviews, observations, and record review, there was not enough supportive evidence to concur with the reported allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit Interview conducted and a copy of this report was provided.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981- 3981
LICENSING EVALUATOR NAME: Jose Villalobos	TELEPHONE: (323) 980-4939
LICENSING EVALUATOR SIGNATURE:	DATE: 05/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/13/2024

LIC9099 (FAS) - (06/04)

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