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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602069
Report Date: 11/20/2020
Date Signed: 11/21/2020 12:13:58 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 DR #100
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
11/13/2020 and conducted by Evaluator Jennifer Jones
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20201113161412
FACILITY NAME:PALMCREST GRAND RESIDENCEFACILITY NUMBER:
198602069
ADMINISTRATOR:LESLY FIGUEROAFACILITY TYPE:
740
ADDRESS:3503 CEDAR AVENUETELEPHONE:
(562) 595-4551
CITY:LONG BEACHSTATE: CAZIP CODE:
90807
CAPACITY:262CENSUS: 106DATE:
11/20/2020
UNANNOUNCEDTIME BEGAN:
10:38 AM
MET WITH:Lesly Figueroa, Administrator TIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Resident's call light is not working
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Jennifer Jones and Jade Jordan initiated a complaint investigation and delivered findings 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 via Facetime with Administrator, Lesly Figueroa. LPAs explained the purpose of this telephonic visit is to gather information regarding the complaint allegation.

On 11/20/20, LPAs, Administrator, Lesly Figueroa and Executive Assistant, Katie Bautista conducted a tour of the facility inside and out including the break room. LPAs and staff 1 and 2 check the signal systems in rooms 104, 105, 122 139, 208 , 219, 225, 230, 308, 311 and 312. LPAs requested a staff and client roster and a maintenance log of when the facility signal systems lights are checked in resident's rooms.

The investigation revealed the following: For allegation (Resident's call light is not working) It was alleged that the facility call lights are not working for residents. During the tour, LPAs and staff toured the facility and
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Angela J Kendrick
LICENSING EVALUATOR NAME: Jennifer Jones
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2020
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 2
Control Number 11-AS-20201113161412
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 DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: PALMCREST GRAND RESIDENCE
FACILITY NUMBER: 198602069
VISIT DATE: 11/20/2020
NARRATIVE
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checked the call lights and signal systems in rooms 104, 105, 122 139, 208 , 219, 225, 230, 308, 311 and 312. The intercom and call buttons worked in all resident rooms. LPAs also checked the signal system in the staff station and observed the signal light notify staff for the rooms LPAs randomly selected to check. On 11/20/20, LPAs interviewed residents 1-10 who stated that their call lights work in their rooms. Residents 1-10 stated that staff come shortly after they call them. Residents 1-10 stated that if there is a problem with the system, staff comes out right away to fix it. Staff 1-7 revealed during their interviews that they have not received any complaints from residents stating that their call light wasn't working. The administrator stated that maintenance checks the calls lights monthly to make sure they are working for residents .





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 allegation is unsubstantiated.

A telephonic exit interview was conducted with Administrator Leslie Figueroa and a hard copy was provided via email for signature
SUPERVISORS NAME: Angela J Kendrick
LICENSING EVALUATOR NAME: Jennifer Jones
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2