198602069-3-26-2021-11-AS-EMAZ-C7BVF4-20210929162316

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602069
Report Date: 03/24/2021
Date Signed: 03/26/2021 05:36:00 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
MONTERY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/28/2020 and conducted by Evaluator Stephanie Cifuentes

COMPLAINT CONTROL NUMBER: 11-AS-20201228135829

FACILITY NAME:	PALMCREST GRAND RESIDENCE		FACILITY NUMBER:	198602069
ADMINISTRATOR:	LESLY FIGUEROA		FACILITY TYPE:	740
ADDRESS:	3503 CEDAR AVENUE		TELEPHONE:	(562) 595-4551
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90807
CAPACITY:	262	CENSUS: 109	DATE:	03/24/2021
		UNANNOUNCED	TIME BEGAN:	03:04 PM
MET WITH:	Lesly Figueroa		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff failed to assist resident.
Resident belongings not safeguarded.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA Stephanie Cifuentes) initiated a complaint investigation for the allegations listed above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s subsequent complaint investigation was conducted telephonically with Lesly Figueroa, the facilities Executive Director. LPA explained that the purpose of today’s visit was to deliver complaint findings.

The investigation consisted of the following:

On 1/4/2021 LPA Cifuentes interviewed administrator Lesly Figueroa and toured facility grounds. On 2/2/2021 LPA interviewed resident 1-resident 11 and staff 2-staff 6. LPA requested and received the following documents: Staff and Client rosters, facility theft and loss policy.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7763
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2021

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-20201228135829

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
MONTERY PARK, CA 91754

FACILITY NAME: PALMCREST GRAND RESIDENCE	FACILITY NUMBER: 198602069
	VISIT DATE: 03/24/2021

NARRATIVE

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LPA interviewed resident 1( R1), who stated they had bought multiple bottles of acetone online to clean their nails and computer parts. R1 stated they waited for the package, and when tracking showed the package arrived they checked in with facility staff and where told to speak to administrator Lesly Figueroa. Ms. Figueroa told R1 that they could not give them the bottles to keep in their room as their roommate was not stable. R1 stated they were now in a room by themselves and had a locked drawer so wanted their property back. Administrator told R1 item could not be found, so she offered to compensate R1 for the item or buy it for them.

On 2/2/2021 LPA Cifuentes spoke with resident 2-resident 11 regarding issues with their mail and the assistance they had received at the facility. Ten out of the eleven residents stated they had no problems with their mail and ten out of the eleven residents interviewed also stated that they had no issues requesting and getting staff assistance.

Based on LPA’s observation, interviews conducted, and records reviewed, the preponderance of evidence standard has not been met. 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.

Regarding the allegation: Resident belongings not safeguarded

The investigation revealed the following:

On 1/4/2021 LPA Cifuentes spoke to Administrator Lesly Figueroa about the allegation listed above. Ms. Figueroa stated that when an item is reported stolen, a theft and loss form is filled out and an investigation is conducted. The facility tries to recoup the item and could possibly reimburse the resident for the item depending on what amount is on the inventory sheet.

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7763
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20201228135829

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
MONTERY PARK, CA 91754

FACILITY NAME: PALMCREST GRAND RESIDENCE	FACILITY NUMBER: 198602069
	VISIT DATE: 03/24/2021

NARRATIVE

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LPA interviewed R1, who stated they had money stolen from their room. They alerted the administrator, and a week or two later Ms. Figueroa said she would give it back to them. When LPA spoke to R1, part of the money had been paid back.

On 2/22/2021 LPA Cifuentes spoke to resident 2-resident 11. Of the residents interviewed 8 out of 10 stated they had never had anything stolen from them.

On 2/22/2021 LPA Cifuentes spoke with staff 2 -staff 6. Of the staff interviewed, 5 out of 5 stated residents had not had items stolen from them.

LPA conducted a record review of documentation received, which included a copy of the theft and loss policy along with the corresponding California Law.

Exit interview conducted, and a copy of the report was emailed to Lesley Figueroa , executive director.

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Stephanie Cifuentes	TELEPHONE: (661) 644-7763
LICENSING EVALUATOR SIGNATURE:	DATE: 03/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/24/2021

LIC9099 (FAS) - (06/04)

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