198602069-4-12-2022-11-AS-AJKK-CDLLYX-20220418091100

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602069
Report Date: 04/12/2022
Date Signed: 04/12/2022 05:06:42 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
01/25/2022 and conducted by Evaluator Elizabeth Ceniceros

COMPLAINT CONTROL NUMBER: 11-AS-20220125115841

FACILITY NAME:	PALMCREST GRAND RESIDENCE		FACILITY NUMBER:	198602069
ADMINISTRATOR:	PEGGY CLARK		FACILITY TYPE:	740
ADDRESS:	3503 CEDAR AVENUE		TELEPHONE:	(562) 595-4551
CITY:	LONG BEACH	STATE: CA	ZIP CODE:	90807
CAPACITY:	262	CENSUS:	DATE:	04/12/2022
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Administrator, Peggy Clark		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Facility staff member is not adequately trained.
Facility staff are not adequately communicating with resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst/Retired Annuitant (LPA/RA: Elizabeth Ceniceros) conducted an unannounced subsequent visit to the facility at 8:00 a.m. and was greeted by Asst. Administrator (A2: Veronica Gomez); as Administrator (A1: Peggy Clark) was unavailable until 9:00 a.m. LPA/RA Ceniceros spoke to A2 prior to entering the facility to conduct a risk assessment. A2 informed LPA/RA Cenicerso that the facility has no COVID cases nor do any of the residents or staff have symptoms. LPA/RA Ceniceros explained the purpose of this visit is to deliver the findings pertaining to the above-mentioned allegation.

Licensing Program Analyst (LPA) Troy Agard conducted the unannounced 10-Day visit on 02/02/22. During today’s visit, LPA/RA Ceniceros obtained a copy of the facility staff (Med Tech) training records, updated resident roster, facility staff roster & work schedule. LPA/RA toured the facility to observe the mail distribution (photos); conducted interviews with facility staff (S1-S8) at 1:00 p.m. and residents (R1-R8) at 2:30 p.m.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Elizabeth Ceniceros	TELEPHONE: (323) 213-1116
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2022

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-20220125115841

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: 04/12/2022

NARRATIVE

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Regarding Allegation #1: this investigation revealed that the facility provides ongoing continuing education hours of medication training to facility staff who administer medications to the residents. LPA/RA Ceniceros reviewed documentation for medication training topics: “Assisting with Self-Administration of Medications: Guidelines” on 07/01/21; “Common Medications and Their Side Effects” on 07/01/21; “Psychotropic Medications: Anti-psychotics and Beyond” on 07/01/21; “Safely Monitoring the Medication” on 03/06/21; “California RCFE Medication Policies and Procedures” on 03/05/21 and 03/11/21; “Medication Documentation and Safety” on 03/05/21 and 07/01/21; “Introduction to Medication Management” on 03/05/21; “Providing Medication Assistance – California” on 03/05/21. Administrator Peggy Clark stated that the medication training also includes a medication aide training final exam entitled, “Assisted Living Med Aide Training Final Exam” (dated 08/15/21 and 11/30/21). LPA/RA Ceniceros interviewed eight (8) facility staff members (S1-S8) who administer medications; and, the majority indicated that they have received medication training including completing a final exam. LPA/RA Ceniceros interviewed eight (8) residents (R1-R8) who replied that they have not had an issue with facility staff not trained to administer their medication or meeting their daily needs.

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 of OTHER: Facility staff member is not adequately trained is found to be UNSUBSTANTIATED.

Regarding Allegation #2: this investigation revealed that facility staff communicate with the residents. The Administrator, Asst. Administrator, Marketing Director practice an "open-door" policy with the residents. LPA/RA Ceniceros interviewed eight (8) facility staff members (S1-S8); and, the majority indicated that staff communicate with residents and no resident has informed them about a communication problem between them. LPA/RA Ceniceros interviewed eight (8) residents (R1-R8); and, the majority agreed that they are able to communicate with facility staff and are aware of an “open-door” policy with Administration.

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 of PERSONAL RIGHTS: Facility staff are not adequately communicating with residents is found to be UNSUBSTANTIATED.

An exit interview was conducted and copy of the Complaint Report was provided to Administrator (Peggy Clark).

SUPERVISOR'S NAME: Janae Hammond	TELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Elizabeth Ceniceros	TELEPHONE: (323) 213-1116
LICENSING EVALUATOR SIGNATURE:	DATE: 04/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2022

LIC9099 (FAS) - (06/04)

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