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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198601940
Report Date: 08/28/2023
Date Signed: 08/28/2023 02:32:07 PM

Substantiated


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
08/21/2023 and conducted by Evaluator Angelica Rea
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20230821115851
FACILITY NAME:VILLA FLORAFACILITY NUMBER:
198601940
ADMINISTRATOR:ROSALINDA BUENVIAJEFACILITY TYPE:
735
ADDRESS:10932 CARMENITA RD.TELEPHONE:
(562) 941-5249
CITY:WHITTIERSTATE: CAZIP CODE:
90605
CAPACITY:34CENSUS: 25DATE:
08/28/2023
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Joel AlonzoTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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Staff have not addressed the bed bug infestation
Staff have not repaired the facility's dryers
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Angelica Rea conducted an initial complaint visit in response to the allegations listed above. LPA met with caregiver Ely Vlas. Ms. Vlas called administrator Joel Alonzo to let him know of the visit. Mr. Alonzo arrived at the facility a short time later and assisted with the visit.

The investigation consisted of interviews with Administrator, staff #1, staff #2, and resident #1 - resident #3, tour of facility, and review of pest control invoices. Administrator stated that he did not have copies of invoices for dryer repair(s).

Regarding the allegation that staff have not addressed the bed bug infestation, the investigation revealed the following: Administrator and staff interviewed confirmed the allegation. Administrator stated that they have a contract with a pest control company, but there are several rooms that currently have a bed bug problem. Administrator and staff stated the following rooms have a problem with bed bugs: Rooms 101, 103, 301, 302, and 304.
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Angelica Rea
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023
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 3
Control Number 28-AS-20230821115851
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: VILLA FLORA
FACILITY NUMBER: 198601940
VISIT DATE: 08/28/2023
NARRATIVE
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 Administrator stated that the pest control company was coming to the facility on today's date. However, Administrator received a phone call from pest control company, while LPA was present, and the pest control company rescheduled for 8/29/23. Residents interviewed corroborated the allegation. Two out of three residents stated that there are bed bugs at the facility.

Regarding the allegation that staff have not repaired the facility's dryers, the investigation revealed the following: The facility has 2 set(s) of washer and dryers, in Unit 1 and in Unit 3. Administrator and staff interviewed confirmed the allegation. They stated that the facility dryer(s) in Unit 1 and Unit 3 have been out of order for several months. Administrator stated that the company they are leasing the washer and dryer from, said there are parts that have to be ordered, and they are waiting for those parts. Residents interviewed corroborated the allegation. They stated that both the washer and dryer in Unit 3 are in disrepair, and in Unit 1, the dryer is in disrepair. LPA observed the following in Unit 3: an out of order sign on the washer, and observed that the dryer starts and spins, but is not warm enough to dry clothes. LPA observed the following in Unit 1: the dryer was unplugged and not in use, the washer appears to be operational.

Based on record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Deficiencies are being cited according to California Code of Regulations, Title 22 Division 6, Chapter 1.

An exit interview was conducted with Mr. Alonzo. A copy of the report and appeal rights were provided.
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Angelica Rea
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20230821115851
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: VILLA FLORA
FACILITY NUMBER: 198601940
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/28/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/30/2023
Section Cited
CCR
80087(a)(1)
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(a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. (1) The licensee shall take measures to keep the facility free of flies and other insects.
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Administrator will maintain a contract with pest control company to address the bed bug problem, until the facility is free of bed bugs. Pest control company is to tour entire facility to observe which room(s) have bed bug activity. Administrator will provide LPA with detailed monthly reports, until the facility is free of bed bugs.
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This requirement has not been met as evidenced by: Administrator, staff #1, staff #2 and 2 out of 3 residents interviewed stated that there are bed bugs at the facility.
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Administrator will comply with all recommendations given by pest control company, including replacing resident mattresses, if that is needed. Administrator will ensure that first visit is conducted by 8/29/23, and will send copy of report to LPA.
Type B
09/11/2023
Section Cited
CCR
80087(a)
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(a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.
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Administrator will ensure that the facility has a working washer and dryer by POC due date. Administrator will either repair the washer and 2 dryers that are currently not working, or will purchase a new washer and 2 dryers for the facility. Administrator will send proof of correction to LPA by POC due date.
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This requirement is not being met as evidenced by: Administrator, staff #1, staff #2, and 3 out of 3 residents confirmed that 1 washer, and 2 dryers are not working at the facility.
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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.
NAME OF LICENSING PROGRAM MANAGER: Lisa Hicks
NAME OF LICENSING PROGRAM ANALYST: Angelica Rea
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 08/28/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2023
LIC9099 (FAS) - (06/04)
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