198602069-1-22-2025-11-AS-EMAZ-DEGTF6-20250305134100

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602069
Report Date: 07/30/2024
Date Signed: 01/22/2025 01:21:33 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/22/2024 and conducted by Evaluator Antonine Richard

COMPLAINT CONTROL NUMBER: 11-AS-20240722162337

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: 128	DATE:	07/30/2024
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	PEGGY CLARK		TIME COMPLETED:	03:50 PM

ALLEGATION(S):

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Staff does not have adequate training to care for resident.
Staff cannot communicate with resident due to language barrier.

INVESTIGATION FINDINGS:

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The original LIC9099 and LIC9099C dated 07/30/2024, are being amended to remove modifier. The revised LIC9099 and LIC9099C dated 01/22/2024. The amendment does not change the findings of this investigation.
On 07/30/2024, Licensing Program Analyst (LPA) Antonine Richard conducted a complaint investigation at the above facility to address the following allegations. LPA met with Administrator Veronica Gomez and explained the purpose of today's visit.

The investigation consisted of the following:
During today's investigation, LPA toured the facility, Interviewed ten (10) residents, seven (7) staff members, which included the Assistant Administrator, Marketing Director, Caregiver Supervisor. LPA reviewed and collected facility records.

Continue to LIC9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Antonine Richard	TELEPHONE: (323) 516-4092
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024

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-20240722162337

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: PALMCREST GRAND RESIDENCE	FACILITY NUMBER: 198602069
	VISIT DATE: 07/30/2024

NARRATIVE

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Allegation: Staff does not have adequate training to care for residents.

It is alleged that staff does not have adequate training to care for resident, complainant states that staff S1 is the real problem and does whatever and threaten to fire various caregiver. On 07/30/2024, records reviewed showed S1 had forty hours of mandatory training of care giver for residents. LPA interviewed seven(7) staff members (S1-S7) 7 out of 7 staff denied the allegation. LPA interviewed the assistant administrator S2. S2 stated that they have the required knowledge for providing care and supervision needed to the residents. LPA interviewed seven staff (7) (S1-S7) all of whom stated that they were given on-the-job training and forty-hour training and have the appropriate experience, which provides knowledge and skills to perform their jobs safely and effectively. S2-S7 stated that S1 never threatened to fire them. This is the first-time hearing something like that. LPA interviewed ten residents (R1-R10) 8 out of 10 denied the allegation and overwhelmingly stated that they are well cared for.

Based on interviews, observation, information received, and records reviewed there was not enough sufficient evidence to support the allegation. 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 deemed unsubstantiated.

Continue LIC9099-C

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Antonine Richard	TELEPHONE: (323) 516-4092
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20240722162337

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245

FACILITY NAME: PALMCREST GRAND RESIDENCE	FACILITY NUMBER: 198602069
	VISIT DATE: 07/30/2024

NARRATIVE

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Allegation: Staff cannot communicate with the resident due to the language barrier.

It is alleged staff cannot communicate with residents due to the language barrier. LPA interviewed ten (10) Residents (R1-R10) 9 out of 10 stated that they did not have an issue communicating with the staff; when they needed help, the staff did help them. LPA interviewed ten (10) residents (R1-R10) 9 out of 10 stated that when they need help the new staff do help them. On 07/30/2024, the department had no issues communicating with the staff during the visit. During interviews with seven (7) staff members (S1-S7), all the staff were asked if they had any issues communicating with residents, 6 out of 7 staff, denied the allegation and stated they had no problems communicating with residents. LPA interviewed ten residents (R1-R10) and asked if they had any preferred language spoken to them. All the residents, 10 out of 10, stated that they do not have any preferred language as long as the staff helps them when they need help.

Based on interviews, observation, and information received, there was not enough sufficient evidence to support the allegation. 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 deemed unsubstantiated.

No deficiencies cited. Exit interview was conducted a copy of the report was provided to assistant Administrator Peggy Clark.

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Antonine Richard	TELEPHONE: (323) 516-4092
LICENSING EVALUATOR SIGNATURE:	DATE: 07/30/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024

LIC9099 (FAS) - (06/04)

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