198601838-2-7-2023-28-AS-LHIS-CP2LBY-20230214073732

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601838
Report Date: 02/07/2023
Date Signed: 02/07/2023 02:26:43 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
01/25/2023 and conducted by Evaluator Jewel Baptiste

COMPLAINT CONTROL NUMBER: 28-AS-20230125085536

FACILITY NAME:	DOWNEY RETIREMENT CENTER		FACILITY NUMBER:	198601838
ADMINISTRATOR:	MICHELE R GOODNEY		FACILITY TYPE:	740
ADDRESS:	11500 DOLAN AVENUE		TELEPHONE:	(562) 869-2416
CITY:	DOWNEY	STATE: CA	ZIP CODE:	90241
CAPACITY:	252	CENSUS: 118	DATE:	02/07/2023
		UNANNOUNCED	TIME BEGAN:	12:17 PM
MET WITH:	Administrator Brandie Mendibles		TIME COMPLETED:	02:41 PM

ALLEGATION(S):

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Staff yelled at resident in care.
Staff did not assist with resident's grooming needs.

INVESTIGATION FINDINGS:

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On 2/7/2023 at 12:17 p.m., Licensing Program Analyst (LPA) Jewel Baptiste made an unannounced subsequent complaint visit to the facility regarding the above-mentioned allegations. LPA Baptiste met with Assistant Administrator Jason Perez and explained the purpose of the visit. Administrator Brandie Mendibles arrived at 1:16 p.m. and assisted with the rest of the visit.

On 01/31/23, LPA Baptiste made an initial visit and completed the following: A physical plant tour and interviews with the Administrator, and residents (R2- R7). R1's file was reviewed. The following documents were obtained: Staff Roster, Resident roster, and Physician Report.

On today’s visit LPA Baptiste interviewed Resident#1 (R1) and Resident#8 through Resident #11 (R8-R11). LPA also interviewed Staff#1 and Staff#2 (S1-S2). LPA also obtained a copy of Resident #1 shower schedule.
Report continued on 9099c

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 213-1556
LICENSING EVALUATOR NAME: Jewel Baptiste	TELEPHONE: (323) 400-9594
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

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-20230125085536

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: DOWNEY RETIREMENT CENTER	FACILITY NUMBER: 198601838
	VISIT DATE: 02/07/2023

NARRATIVE

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The investigation reveals the following: Regarding " Staff yelled at resident in care.", it is alleged that S1 yelled at R1. The Administrator and 2/2 staff interviews denied the allegation stating that staff has never yelled at the residents at the facility and the facility has not received complaints corroborating the allegation. 10/11 residents denied the allegations stating that staff has never raised their voice at them or other residents. 1/11 residents stated that S1 yelled and was condescending during their showers.

The investigation reveals the following: Regarding "Staff did not assist with resident's grooming needs ", it is alleged that the staff do not want to assist R1 with grooming. The administrator stated staff has always assisted residents when needed and R1 is upset when staff cannot come right away to assist. 2/2 staff stated they have always responded to the residents and have not heard the residents complain about not getting assistance. 10/11 residents confirmed the facility staff has always responded and go out of their way to assist them. 1/11 residents stated facility staff do not assist with grooming.

Based on LPA's observation, interviews and file review the investigation revealed: 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 allegations are UNSUBSTANTIATED.

Exit interview conducted with Brandie Mendibles and a copy of this record provided.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 213-1556
LICENSING EVALUATOR NAME: Jewel Baptiste	TELEPHONE: (323) 400-9594
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC9099 (FAS) - (06/04)

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