198601962-3-14-2021-28-AS-MVAO-BZLPTS-20210330113625

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601962
Report Date: 03/09/2021
Date Signed: 03/14/2021 11:31:08 AM

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
06/16/2020 and conducted by Evaluator Nicol Wesley

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20200616082152

FACILITY NAME:	SOUTHLAND LIVING		FACILITY NUMBER:	198601962
ADMINISTRATOR:	TRAN, VICTORIA		FACILITY TYPE:	740
ADDRESS:	11701 STUDEBAKER ROAD		TELEPHONE:	(562) 406-7326
CITY:	NORWALK	STATE: CA	ZIP CODE:	90650
CAPACITY:	75	CENSUS: 44	DATE:	03/09/2021
		UNANNOUNCED	TIME BEGAN:	12:06 PM
MET WITH:	Victoria Tran		TIME COMPLETED:	12:07 PM

ALLEGATION(S):

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Staff speaks to resident(s) in an inappropriate manner.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nicol Wesley initiated a complaint investigation for the allegation 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 Administrator Victoria Tran.

The investigation consisted of the following: LPA Wesley conducted a telephonic interview and requested copy of: staff and resident roster to be faxed/emailed by 06/24/20. LPA also interviewed the Administrator Victoria Tran, staff, and residents regarding the above mentioned allegation.

The investigation reveal the following: regarding allegation staff speaks to resident(s) in an inappropriate manner. LPA Wesley conducted a telephonic visit and interviewed a random selection of residents #1-#5(R1-R5),
Continued on LIC 9099C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rebecca Orendain	TELEPHONE: (323) 981-3961
LICENSING EVALUATOR NAME: Nicol Wesley	TELEPHONE: (323) 981-3975
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2021

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-20200616082152

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: SOUTHLAND LIVING	FACILITY NUMBER: 198601962
	VISIT DATE: 03/09/2021

NARRATIVE

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Administrator, and a random selection of staff #1-#2(S1-S2). R1-R5 were interviewed and all were consistent with statements advising that Administrator Victoria Tran or any other staff has never often spoke to them in an inappropriate manner and they never heard the Administrator speak to other staff or residents in an inappropriate manner. R1-R5 also said staff working in the facility have never spoken to them in an inappropriate manner nor have they heard the staff speaking to any other residents in an inappropriate manner. During the interview with R1 they mentioned that sometimes the Administrator appears to be in a pissy mood, but they never acted inappropriate. R3 was interviewed and stated the Administrator and staff are nice and treats them good and they have no complaints, R4 was interviewed and said "I like her very much, she's really nice and knows exactly what to do." LPA Wesley interviewed staff #1 and staff #2 who advised that they have never witnessed the Administrator act inappropriate with them, any of the residents or any other staff in the facility. S1 and S2 also said they have never spoke inappropriate to any residents, or staff and has never witnessed any of the staff act inappropriately with any residents or other staff. Administrator Victoria Tran was interviewed and said she has never mistreated or spoken to any of the residents or staff inappropriately and has never witness any of the staff mistreat or speak to the residents inappropriately. There is no evidence to support the allegation: Staff speaks to resident(s) in an inappropriate manner.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. A telephonic exit interview was conducted with Administrator Victoria Tran, and a hard copy was provided via email to obtain signature. There are no citations issued, exit interview conducted.

SUPERVISOR'S NAME: Rebecca Orendain	TELEPHONE: (323) 981-3961
LICENSING EVALUATOR NAME: Nicol Wesley	TELEPHONE: (323) 981-3975
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2021

LIC9099 (FAS) - (06/04)

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