198602099-6-13-2024-11-AS-UCOL-D86PZP-20240815114552

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602099
Report Date: 06/13/2024
Date Signed: 06/13/2024 04:54:52 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, 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
06/03/2024 and conducted by Evaluator Socorro Leandro

COMPLAINT CONTROL NUMBER: 11-AS-20240603122041

FACILITY NAME:	CORAL OAKS CARE LIVING		FACILITY NUMBER:	198602099
ADMINISTRATOR:	ELEANOR BARRIENTOS		FACILITY TYPE:	740
ADDRESS:	4271 CARLIN AVE		TELEPHONE:	(310) 763-4881
CITY:	LYNWOOD	STATE: CA	ZIP CODE:	90262
CAPACITY:	84	CENSUS: 67	DATE:	06/13/2024
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Administrator - Ellen Barrientos		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff did not seek medical attention for a resident in care.
Staff are abusive towards a resident in care.
Staff discriminates against a resident in care.

INVESTIGATION FINDINGS:

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On 06/13/2024 at around 02:00 PM Licensing Program Analyst (LPA) Leandro continued a complaint investigation regarding the allegations listed above. LPA met with Administrator Ellen Barrientos and the purpose of the visit was explained.

The investigation consisted of the following: During today’s investigation LPA requested Resident 1’s (R1) records. LPA interviewed 5 out of 28 staff and 6 out of 67 residents. LPA reviewed facility records which consisted of resident roster, staff roster, staff trainings, etc. LPA reviewed R1’s records which consisted of unusual incident reports, medical records, physicians report, etc.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Socorro Leandro	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 06/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024

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-20240603122041

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: CORAL OAKS CARE LIVING	FACILITY NUMBER: 198602099
	VISIT DATE: 06/13/2024

NARRATIVE

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The investigation revealed the following:

Regarding the allegation “Staff did not seek medical attention for a resident in care,” it is being alleged that on 05/30/2024 staff did not call for help therefore resident had to call ambulance. 6 out 6 resident interviews indicated that staff assist them with medical attention. 5 out 5 staff denied the allegation. 5 out of 5 staff attempted to assist R1 but she refused. 2 staff members indicated that they offered to call for an Uber and take R1 to kaiser but R1 refused; R1 told them that she will call 911 herself. An unusual incident report dated 05/30/2024 states that R1 "has been refusing treatment,” R1 "agreed to go to kaiser for treatment,” moreover both Administrator and Assistant Administrator counselled R1. Regarding the allegation, the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the allegation is unsubstantiated.

Regarding the allegation “Staff are abusive towards a resident in care” it is being alleged that staff speaks to residents in an aggressive and abusive behavior. 6 out 6 resident interviews denied the allegation. 5 out of 5 staff denied the allegation. R1 is diagnosed with borderline personality disorder and according to her record review and interviews conducted she has a history of verbally fighting with staff and residents. Regarding the allegation, the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the allegation is unsubstantiated.

Regarding the allegation “Staff discriminates against a resident in care” it is being alleged that due to residents’ medical diagnosis staff discriminates against them. 6 out of 6 resident interviews denied the allegation. 5 out of 5 staff interviews denied the allegation. Regarding the allegation, the allegation may have happened or is valid, but there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the allegation is unsubstantiated.

No citations issued at this time.

An exit interview was conducted, and a copy of this report was left with the Administrator.

SUPERVISOR'S NAME: Ulysses Coronel	TELEPHONE: (323) 981-1755
LICENSING EVALUATOR NAME: Socorro Leandro	TELEPHONE: 323-981-1755
LICENSING EVALUATOR SIGNATURE:	DATE: 06/13/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/13/2024

LIC9099 (FAS) - (06/04)

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