<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198602099
Report Date: 03/12/2021
Date Signed: 03/14/2021 09:40:39 AM



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
02/22/2021 and conducted by Evaluator Ulysses Coronel
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20210222154958
FACILITY NAME:CORAL OAKS CARE LIVINGFACILITY NUMBER:
198602099
ADMINISTRATOR:ELEANOR BARRIENTOSFACILITY TYPE:
740
ADDRESS:4271 CARLIN AVETELEPHONE:
(310) 763-4881
CITY:LYNWOODSTATE: CAZIP CODE:
90262
CAPACITY:84CENSUS: 63DATE:
03/12/2021
UNANNOUNCEDTIME BEGAN:
04:05 PM
MET WITH:Eleonor BarrientosTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Resident's food is being tampered with.
Facility is not following resident's dietary requests.
Staff cancel resident's appointments.
Staff does not give resident medication on a regular basis.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Ulysses Coronel 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 complaint investigation was conducted telephonically with Eleonor Barrientos the facility administrator.

The investigation consisted of the following: On 02/25/2021 LPA Coronel conducted a virtual tour of the physical plant, which includes the facility entrance, medication room, activity area, dining area, kitchen, pantry and bedroom hallways. LPA interviewed 10 out of 63 residents, 4 staff and the administrator via zoom video call. LPA requested copies facility records and resident R1's resident records. On 03/02/2021 LPA interviewed witness W1. On 03/12/2021 LPA reviewed facility records and R1’s resident records.

The investigation revealed the following: On 02/25/2021 9 out of 10 residents interviewed did not have any issues with the way they were being treated at the facility, resident R1 stated “No, they treat me bad here, it's horrible except for S3 here.”, resident R2 stated: “Yes, we are treated well here, the staff are caring and very knowledgeable.”
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ulysses CoronelTELEPHONE: (951) 212-8917
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 11-AS-20210222154958
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: CORAL OAKS CARE LIVING
FACILITY NUMBER: 198602099
VISIT DATE: 03/12/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
On 02/25/2021 staff S4 stated: "R1 accused me of putting something to her food, but I did not do such things.” On 03/02/2021 witness W1 stated “R1 has a history of major depressive disorder w/ recurrent psychotic features, which may have contributed the complaints.” Regarding the allegation: Resident's food is being tampered with.” We have found the allegation as Unsubstantiated: 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.

On 02/25/2021 9 out of 10 residents interviewed did not have any issues with the food being served at the facility, resident R1 stated "The food is too salty I have hypertension, so I get headaches when it’s too salty. I'm going to ask my doctor to give me an order for special diet.", resident R7 stated: "Yes, we are given options, there are alternative menus." On 02/25/2021 Administrator stated: "I did receive concerns from R1 regarding the food, I told kitchen staff to set aside reduced salt or no-added-salt food for R1. But then R1 complains that the food is bland. We provide condiments like salt and pepper to residents so they can flavor the food to their taste." Regarding the allegation: “Facility is not following resident's dietary requests.” We have found the allegation as Unsubstantiated: 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.

On 02/25/2021 10 out of 10 residents interviewed did not have any issues getting help with doctor’s appointments, R1 stated that: “The other day I missed my doctor's appointments. It was the transportation company, they cancelled on me." On 02/25/2021 staff S1 stated that “The case manager sets the doctor’s appointments for R1.” On 02/25/2021 The Administrator stated: "R1 has been having issues with the transportation recently. The transportation company were having issues with R1’s recent doctor’s appointment and they cancelled on R1 the other day." Regarding the allegation: “Staff cancel resident's appointments.” We have found the allegation as Unsubstantiated: 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.

On 02/25/2021 9 out of 10 residents interviewed did not have any issues getting assistance with their medications, resident R1 stated: “Sometimes I don't get medications in the afternoon.", resident R2 stated “I have no problems, I've also been getting my PRNs as needed.”
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ulysses CoronelTELEPHONE: (951) 212-8917
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 11-AS-20210222154958
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: CORAL OAKS CARE LIVING
FACILITY NUMBER: 198602099
VISIT DATE: 03/12/2021
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
On 02/25/2021 staff S1 stated “R1 has not missed medications, we recently started medication log, where R1 would initial every medication explained to them before taking them.” On 03/12/2021 LPA reviewed R1’s medication administration logs and observed that “all of R1’s prescribed medications were administered from 12/01/2020 to 02/25/2021.” Regarding the allegation: “Staff does not give resident medication on a regular basis.” We have found the allegation as Unsubstantiated: 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.

A telephonic exit interview was conducted with Eleonor Barrientos, and a hard copy was provided via email for signature.
SUPERVISOR'S NAME: Janae HammondTELEPHONE: (323) 981-3328
LICENSING EVALUATOR NAME: Ulysses CoronelTELEPHONE: (951) 212-8917
LICENSING EVALUATOR SIGNATURE:

DATE: 03/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3