198602069-6-22-2021-11-AS-JHAD-C4BSU9-20210625141045

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602069
Report Date: 06/22/2021
Date Signed: 06/22/2021 01:00:02 PM

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
06/10/2020 and conducted by Evaluator Jose Calderon

COMPLAINT CONTROL NUMBER: 11-AS-20200610131541

FACILITY NAME:	PALMCREST GRAND RESIDENCE		FACILITY NUMBER:	198602069
ADMINISTRATOR:	STREICHER, RACHEL		FACILITY TYPE:	740
ADDRESS:	3503 CEDAR AVENUE		TELEPHONE:	(562) 595-4551
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90807
CAPACITY:	262	CENSUS: 107	DATE:	06/22/2021
		UNANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	ASST ADMIN PEGGY CLARK		TIME COMPLETED:	10:11 AM

ALLEGATION(S):

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Staff are stealing resident's personal property.

INVESTIGATION FINDINGS:

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THIS LIC9099 SUPERCIDES PRIOR LIC9099,CORRECTION FOR DATE OF MEETING WITH ADMIN

On 06/10/2020 Licensing Program Analyst LPA Kourtney Williams conducted a complaint investigation for the allegation listed above. In accordance with Governor's Proclamation has set forth, LPA is unable to make a physical inspection due to COVID-19. Today’s investigation was conducted by telephonically with Peggy Clarke, Assistant Administrator.

The Investigation consisted of the following: On 08/21/2020 LPA Kourtney Williams interviewed Administrator S1 Russell and interviewed S2 – S10. On 08/21/2020 LPA Williams interviewed R1 – R10 for complaint.

The investigation revealed the following:

Allegation: Staff are stealing resident's personal property.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Jose Calderon	TELEPHONE: (323) 213-1153
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2021

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 11-AS-20200610131541

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: 06/22/2021

NARRATIVE

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It is alleged Staff are stealing resident's personal property. On 08/21/2020 LPA Williams interviewed administrator S1 Russell has not received any reports from staff or residents regarding the theft of any personal property or money and that there is video that covers the hall ways to residents’ room. On 08/21/2020 LPA Williams interviewed R1 – R10, all residents feel safe living at the facility and have never had any personal property stolen or any money missing.

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 Peggy Clark, and a hard copy was provided via email for records.

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Jose Calderon	TELEPHONE: (323) 213-1153
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2021

LIC9099 (FAS) - (06/04)

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