198602243-9-3-2024-28-AS-RORN-D9MPUV-20241001113809

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602243
Report Date: 09/03/2024
Date Signed: 09/03/2024 10:58:11 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 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
08/29/2024 and conducted by Evaluator Sanjay Vaid

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240829151957

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:	09/03/2024
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Direct Staff, Naylet Velasquez		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Staff do not properly maintain the facility

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) S Vaid conducted an unannounced initial 10 day complaint visit regarding the above allegation. LPA met Naylet Velasquez (Med Aide, Direct Staff, Designated Substitute) and explained the reason for the visit. Administrator Rosalie Sandoval arrived shortly after.

During today's visit, LPA reviewed and obtained client and staff roster, LPA toured the physical plant with Designated Sub Naylet Velasquez and did not observe any deficiencies or health and safety concerns. LPA Vaid interviewed Staff 1-3 (S1-S3). LPA interviewed clients 1-4 (C1-C4).

Regarding the allegation: Staff do not properly maintain the facility. It is alleged that the facility is not maintaining the facility and allows foul smell of urine, feces, and mildew to remain within the common restrooms and community showers. Three (3) out of (3) staff deny this allegation. Four (4) out of (4) clients interviewed have no knowledge of the allegation, clients interviewed say that the facility is always cleaning, and staff keeps the facility safe for them. CONTINUED on 809C.......

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Sanjay Vaid	TELEPHONE: 916-215-7924
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2024

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-20240829151957

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: GARFIELD TERRACE LLC	FACILITY NUMBER: 198602243
	VISIT DATE: 09/03/2024

NARRATIVE

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LPA Vaid toured the facility and observed all three community showers and clients personal restrooms (rooms, 31, 13 and 34 were observed to be near the community restrooms) to be clean and without mal odor. LPA did not observe exposed wiring in any the community restrooms, nor the common restroom used by the staff and visitors. Based on observations made, and interviews conducted. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

An exit interview was held and copy of this report was given to Administrator Rosalie Sandoval.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Sanjay Vaid	TELEPHONE: 916-215-7924
LICENSING EVALUATOR SIGNATURE:	DATE: 09/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2024

LIC9099 (FAS) - (06/04)

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