198602405-9-10-2021-11-AS-JHAD-C6TUP8-20210913154508

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602405
Report Date: 08/27/2021
Date Signed: 09/10/2021 11:29:19 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/18/2021 and conducted by Evaluator Ana Soto

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20210818091137

FACILITY NAME:	ANEW DIRECTION ADULT LIVING		FACILITY NUMBER:	198602405
ADMINISTRATOR:	PATRICIA DUFRENNE		FACILITY TYPE:	735
ADDRESS:	2300 S PACIFIC AVE		TELEPHONE:	(909) 210-0365
CITY:	SAN PEDRO	STATE: CA	ZIP CODE:	90731
CAPACITY:	72	CENSUS: 51	DATE:	08/27/2021
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Patricia Dufrenne, Licensee		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Resident sustained unexplained injuries while in care
Facility staff did not assist resident with hygiene needs

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ana Soto initiated a complaint investigation for the allegations listed above.
Due to the situation surrounding a TB exposure, and to implement mitigation
measures, today’s complaint investigation was conducted virtually with Kenneth, the facility
House manager.

The investigation consisted of following: Interviews and Record reviews. On 08/27/21, LPA Soto interviewed Patricia Dufrenne, Licensee, Kenneth, House Manager, Ditas Chantengzo, Medication Technician, Home Health Nurse, and R#1 – R#5. LPA Soto obtained the following documents: Resident Roster, Staff Roster, Home Health Notes & Pictures, R#1’s (Physician’s Report, Clinic discharge papers, Mars (July & August,) Medical Doctor’s notes.)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ana Soto
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

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-20210818091137

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: ANEW DIRECTION ADULT LIVING	FACILITY NUMBER: 198602405
	VISIT DATE: 08/27/2021

NARRATIVE

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Based on the LPA's investigation, the investigation revealed the following. For Allegation #1 – Resident sustained unexplained injuries while in care. The interviews conducted with Licensee, House manager, and Med tech, stated that R#1 did not have lice. They send R#1 to the hospital because R#1 kept scratching R#1’s head, so they send R#1 to the hospital to be checked. When R#1 returned from the hospital, R#1 came back with new prescription medication for the scratches on R#1’s head. R#1 Primary Physician gave R#1 new prescription order. The also stated that the scratches on R#1 head were superficial, not deep or worrisome. R#1 has a behavior where R#1 scratches, bites, and spit out, but only does it to R#1’ self. Interview with Home Health Nurse stated that she checked R#1 ‘s scratches and they were superficial, she noticed while, attending to R#1, R#1 has what one might consider a tick. R#1 just kept scratching R#1 head, R#1 did not have lice or any eggs. R#1 just has a tick for scratching R#1 self, she assumes it’s just a tick. Interviews with R#2 – R#5, stated that they have never sustained any injuries at the facility. They are always taken care of at the facility. Interview with R#1 was not possible, R#1 would only mumble to answers questions. LPA Soto reviewed documents and it showed R#1 has a behavior where R#1 constantly scratches R#1 self. Interviews and records do not concur with the above allegation
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Allegation #2 - Facility staff did not assist resident with hygiene needs. The interviews conducted with Licensee, House manager, and Med tech, stated that R#1, does not like to bathe, R#1 hygiene is horrible. R#1 Refuses to take care of R#1 hygiene issues. Med tech provides clean clothes to R#1, R#1 changes but doesn’t bathe. House manager, Licensee, and Med tech always encourage R#1 to take care of her personal hygiene and even offer to assistance R#1 with the chore, R#1 refuses. Interview with R#1 was not possible, R#1 would only mumble to answers questions. Interview with R#2, stated that R#2 chooses not to take care of R#2 personal hygiene, but also stated that Kenny is always encouraging R#2 to take care of R#2 personal hygiene. Interviews with R#3 – R#5, stated that they take care of their own personal hygiene, the facility doesn’t have to helped them. Interviews conducted do not concur with the allegation above.

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 virtually with Kenneth, House Manager, and a copy was provided via email for signature.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ana Soto
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

LIC9099 (FAS) - (06/04)

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