198602069-6-15-2022-11-AS-UCOL-CG8UF4-20220711153208

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602069
Report Date: 06/15/2022
Date Signed: 06/15/2022 02:38:13 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
06/08/2022 and conducted by Evaluator Troy Agard

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20220608082926

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: 120	DATE:	06/15/2022
		UNANNOUNCED	TIME BEGAN:	10:04 AM
MET WITH:	Peggy Clark		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff finanically abused resident while in care.

INVESTIGATION FINDINGS:

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On 06/15/2022, Licensing Program Analyst (LPA) Troy Agard initiated a complaint investigation to address the allegation listed above. LPA Agard met with Peggy Clark, Administrator and explained the purpose of this visit is to gather information for the complaint and deliver findings.

The investigation consisted of the following: LPA Agard conducted a tour of the facility grounds, interviewed staff, residents, a witness, and reviewed records. LPA Agard requested the following documents, which were received at the time of visit: 1) a copy of the staff roster, 2) a copy of the resident roster, 3) needs and services plans for R1, 4) physician report for R1, 5) police report, 6) bank statement with questionable transactions, 7) inventory list

On 06/17/2022, LPA delivered findings.

Cont. on 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Troy Agard	TELEPHONE: (323) 400-7109
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2022

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-20220608082926

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: 06/15/2022

NARRATIVE

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The investigation revealed the following: Regarding the allegation: Staff financially abused resident while in care. “It’s being alleged that a resident in care had their debit card used by a former staff to make unauthorized purchases.” During interviews, 6 out of 7 staff generally denied the allegation to be true but suspect S3 of financial abuse. 1 staff was unavailable for an interview. On 06/15/2022 at 10:01am S1 states, “staff do not financially abuse residents.” On 06/15/2022 at 10:16am S2 states, “S3 was hired to be an activities person. On Tues, 05/31/2022, they went to go get donuts with R1 and R2. I was under the impression they were going to buy them out of pocket. The next day the daughter of R1 call stating there was activity on R1’s debit card. There were two charges for donuts. The days after, S3 was a no call no show for the next 3 days. That following Monday they came to work. I asked about the charges for the donuts and if they had the card. S3 denied the charges and knowing where R1’s card was. S3 was unavailable for an interview. On 06/15/2022 S4-7 all suspect S3 of financial abuse but could not confirm for sure. On 06/15/2022 at 11:15am S7 states, “I’m not aware of any staff financially abusing R1.”

During interviews, 5 out of 7 residents denied the allegation to be true. 2 were unable to be interviewed due to their diagnoses. R1 and R2 were both unable to interview. On 06/15/2022 at 11:10am R3 states, “I don’t know R1 and anything about their card being stolen. On 06/15/2022 at 11:30am R6 states, “The staff don’t have access to my accounts so they can’t abuse me financially. On 06/15/2022 R3-7 all deny being financially abused. On 06/15/2022 at 10:34am W1 states, “I don’t know for sure. I wasn’t there, obviously. R1 had their debit card and was taken to a shopping center nearby with an individual that works there. That day there were 7 different charges on the card. One of two things happened that day: The employee took R1’s card or it was lost, and someone picked it up. I wasn’t there and it’s pretty hard to prove. Some random stranger could have picked it up. I don’t know if the employee is still there and if they confessed. The police said that there was not enough proof to press charges. I didn’t know R1 had their card in the first place.”

LPA reviewed a copy of R1’s inventory list and did not note a debit card tracked by the relative of R1. LPA reviewed an incident report from the Long Beach Police Department which includes the transactions in question. The police report dated for 06/03/2022 does not indicate a perpetrator.

Based on interviews conducted, and record review, 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 did or did not occur, therefore the allegation is unsubstantiated.

An exit interview was conducted, and a copy of the report was given.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Troy Agard	TELEPHONE: (323) 400-7109
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2022

LIC9099 (FAS) - (06/04)

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