198602243-9-6-2024-28-AS-TVAO-D96UT7-20240916155129

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602243
Report Date: 09/06/2024
Date Signed: 09/06/2024 12:23:14 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/06/2024 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240906094743

FACILITY NAME:	GARFIELD TERRACE LLC		FACILITY NUMBER:	198602243
ADMINISTRATOR:	SANDOVAL, ROSALIE		FACILITY TYPE:	740
ADDRESS:	1435 N GARFIELD AVE		TELEPHONE:	(626) 398-0527
CITY:	PASADENA	STATE: CA	ZIP CODE:	91104
CAPACITY:	60	CENSUS: 30	DATE:	09/06/2024
		UNANNOUNCED	TIME BEGAN:	10:31 AM
MET WITH:	Rosalie Sandoval, Administrator		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Staff does not ensure sliding glass door closes/locks properly.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cynthia Chan conducted a complaint investigation for the allegation listed above. LPA arrived unannounced and met with Administrator, Rosalie Sandoval. The purpose of the visit was explained.

LPA obtained copies of the staff and resident rosters, toured the facility, and conducted interviews.

For allegation - Staff does not ensure sliding glass door closes/locks properly. LPA interviewed Administrator and staff who acknowledge the sliding door is heavy and can be difficult for some residents to open and close. However, the door can be closed and locked properly. Administrator stated that they have sprayed lubricant on the bottom of the sliding door to make it easier to slide. They remind residents to close it and staff will also check to ensure the door is closed. LPA interviewed 4 residents. 3 out of the 4 residents indicated the door is heavy and choose not to use it. They use the other door in the dining room to go in and out instead. One uses the sliding door often and has no issues with it.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Tony Vasallo	TELEPHONE: (323) 981-3977
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024

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 28-AS-20240906094743

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: GARFIELD TERRACE LLC	FACILITY NUMBER: 198602243
	VISIT DATE: 09/06/2024

NARRATIVE

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They do not feel that the sliding door poses a safety concern. During the tour, LPA observed the sliding door in the dining room to be working properly. The door requires a little more force to open and close due to its heaviness, but it is not in disrepair. There is another door in the dining room to access the courtyard. LPA observed 2 individuals utilizing the sliding door without any problems.

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 with the administrator. A copy of this report along with the appeal rights was provided.

SUPERVISOR'S NAME: Tony Vasallo	TELEPHONE: (323) 981-3977
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 09/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/06/2024

LIC9099 (FAS) - (06/04)

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