198602244-12-13-2022-28-AS-RORN-CMXNVN-20230110094811

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602244
Report Date: 12/13/2022
Date Signed: 12/13/2022 11:52:49 AM

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
12/08/2022 and conducted by Evaluator Luis Mora

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20221208113829

FACILITY NAME:	PASADENA ADULT LIVING CENTER		FACILITY NUMBER:	198602244
ADMINISTRATOR:	GARCIA, RUBY		FACILITY TYPE:	735
ADDRESS:	1415 N GARFIELD AVE		TELEPHONE:	(626) 398-9647
CITY:	PASADENA	STATE: CA	ZIP CODE:	91104
CAPACITY:	136	CENSUS: 93	DATE:	12/13/2022
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Ruby Garcia - Administrator		TIME COMPLETED:	12:07 PM

ALLEGATION(S):

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Client is being sexually harassed while in care.
Food is not of quality to meet client's needs.
Client not accorded dignity in relationship with staff.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Luis Mora conducted an unannounced complaint visit to determine the validity of the above-mentioned allegations. LPA met with Ruby Garcia (Administrator) and explained the reason for the visit.

The investigation consisted of the following: LPA obtained copies of the clients and staff rosters, and interviewed Administrator, Staff 1 - Staff 3 (S1 - S3) and Client 1 - Client 9 (C1 - C9). Copies of the December 2022 regular and alternative menu were obtained.

The investigation revealed the following: regarding the allegation "client is being sexually harassed while in care.", it is alleged that a client reported sexual harassment to the administrator. Interviews with administrator and staff denied the allegation and stated that no sexual harassment has occured to any of the clients. Clients interviewed could not corroborate the allegation and stated that they have not been sexually harassed or have seen another client being sexually harassed. (CONTINUED TO LIC 9099C)

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Luis Mora
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2022

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-20221208113829

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: PASADENA ADULT LIVING CENTER	FACILITY NUMBER: 198602244
	VISIT DATE: 12/13/2022

NARRATIVE

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Regarding the allegation "food is not of quality to meet client's needs", it is alleged that the food is too greasy and the salads provided are too small. Administrator and staff interviewed denied the allegation and stated that the food is not too greasy and that the salads are served in a huge plate. They also stated that there is an alternative menu that has foods like sandwiches and salads. Clients interviewed could not corroborate the allegation and stated that the food is not greasy and provide a good portion of salad.

Regarding the allegation "client not accorded dignity in relationship with staff", it is alleged that a client was threatened to be kicked out due to reporting sexual harassment and also receives mean looks when asking for a bigger salad bowls. Administrator and staff interviewed denied the allegation. They stated no clients have been threatened to be kicked out of the facility and no mean looks are given when clients ask for seconds. Clients interviewed could not corroborate the allegation and stated that they have not been threatened or seen another client being threatened. They also stated that the kitchen staff do provide seconds and they do not get mad or give the clients a mean look.

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.

Exit interview held and a copy of the report was provided

NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Luis Mora
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 12/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2022

LIC9099 (FAS) - (06/04)

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