198602243-11-4-2024-28-AS-LHIS-DAXSEP-20241112124905

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602243
Report Date: 11/04/2024
Date Signed: 11/04/2024 03:45:35 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
10/31/2024 and conducted by Evaluator Alberto Lopez

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20241031145838

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: 33	DATE:	11/04/2024
		UNANNOUNCED	TIME BEGAN:	09:53 AM
MET WITH:	Rosalie Sandoval, Administrator		TIME COMPLETED:	03:58 PM

ALLEGATION(S):

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Facility is unsanitary.
Facility retaining bedridden residents without approved fire clearance.
Facility staff not equipped to care for residents.

INVESTIGATION FINDINGS:

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Licensee Program Analysts (LPAs) Alberto Lopez, Luis De Leon, and Myra Cota made an unannounced compliant visit to investigate the above allegations. LPAs met with Naylet Velazquez, Medication Aide and Administrator Rosalie Sandoval arrived a short time later and assisted with the visit.

The investigation consisted of LPAs interviewing four (4) staff (S#1-S#4), and seven (7) residents (R#1-#7), reviewing and obtaining staff and resident rosters, medical documentation for R2-R7.

Allegation: Facility is unsanitary. It is alleged that there is feces in R4 bed.

The investigation revealed: LPAs interviewed four (4) staff and four (4) of four (4) staff denied the allegation.
LPAs interviewed seven (7) residents and seven (7) of seven (7) residents could not corroborate the allegation. LPAs took tour of the facility and random rooms and all were observed to be clean.
(Continued on 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Alberto Lopez	TELEPHONE: 323-980-4926
LICENSING EVALUATOR SIGNATURE:	DATE: 11/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2024

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-20241031145838

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: 11/04/2024

NARRATIVE

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One (1) staff stated that R4 is known to make a mess when they use the bathroom, however, staff promptly clean R4 room as much as necessary. LPAs did not observe any feces anywhere in R4 room during the entire visit nor any of the others rooms inspected. There is no evidence to support this allegation.

Allegation: Facility retaining bedridden residents without approved fire clearance. It is alleged that the facility is accepting and retaining bedridden residents without fire clearance.

LPAs interviewed four (4) staff and all four (4) staff stated they have no bedridden residents at the facility at this time.

LPAs interviewed seven (7) residents including the four (4) mentioned in the allegations and seven (7) of seven (7) residents were unable to corroborate the allegations. All seven (7) residents stated they are able to get in and out of bed on their own. Medical documentation for the four (4) residents alleged to be bedridden showed that they are all non-ambulatory. LPAs observation did not observe a health or safety hazard for the residents at the time of visit. There is not enough evidence to substantiate this allegation.

Allegation: Facility staff not equipped to care for residents. It is alleged that facility staff are not properly equipped to assist in lifting residents.

LPAs interviewed four (4) staff and all four (4) staff denied the allegation. Administrator stated that the facility is not required to have a Hoyer Lift or back brace support for staff because they don't do any lifting of any of the residents. All they do is assist in changing the residents and assist with transferring. Administrator stated they do not lift any resident. LPAs interviewed seven (7) residents and four (4) our of seven (7) could not corroborate the allegation.

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 allegations are unsubstantiated.

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

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Alberto Lopez	TELEPHONE: 323-980-4926
LICENSING EVALUATOR SIGNATURE:	DATE: 11/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2024

LIC9099 (FAS) - (06/04)

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