198602406-12-23-2020-11-AS-MCAA-BWL2LT-20201223163001

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602406
Report Date: 09/04/2020
Date Signed: 12/23/2020 04:03:27 PM

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
07/15/2020 and conducted by Evaluator Pamela Bunker

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20200715100032

FACILITY NAME:	ALABASTER ELDERLY CARE		FACILITY NUMBER:	198602406
ADMINISTRATOR:	DAVIS, DELORES		FACILITY TYPE:	740
ADDRESS:	9825 8TH AVENUE		TELEPHONE:	(323) 971-2964
CITY:	INGLEWOOD	STATE: CA	ZIP CODE:	90305
CAPACITY:	6	CENSUS: 5	DATE:	09/04/2020
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Delores Davis		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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Resident is being financially abused while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint tele-visit on Friday, September 04, 2020 at 11:30 P.M., Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19) Pandemic, and to implement mitigation measures, today’s complaint investigation was conducted telephonically with the facility Licensee Delores Davis. LPA Bunker explained the purpose of today's tele-investigation.

Investigation consisted of the following: LPA Bunker interviewed two staff (S1-S2) and five residents (R1-R5) LPA Bunker attempted to interview R2 and R3 they are non-verbal and was unable to articulate. LPA Bunker asked questions relevant to the nature of the complaint. Allegation: Resident is being financially abused while in care. Staff and residents interviewed stated that residents are not being financially abused. Staff and residents stated the facility doesn't handle any of the resident’s funds. R1 handles his own banking and money. R2-R5 all have Power of Attorneys (POAs) that handles their funds.
See continued LIC9099-C page #2

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Michael Cava	TELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Pamela Bunker	TELEPHONE: (323) 213-1113
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2020

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-20200715100032

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: ALABASTER ELDERLY CARE	FACILITY NUMBER: 198602406
	VISIT DATE: 09/04/2020

NARRATIVE

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Continued LIC9099-C page #2

Investigation revealed the following: Interviews were conducted via FaceTime with two staff (S1-S2) and five residents (R1-S5). During the interviews, residents stated that they had no problems with their finances. Residents stated that they are very happy at the facility and happy with how they are treated by staff.
Staff and residents stated staff doesn't use residents debit cards for online purchases, nor does staff use residents debit cards at the ATM. Staff and residents stated residents are not being financially abused. The facility staff doesn't handle any of the resident’s funds. Residents stated staff provided them with the necessary care and supervision and their care needs are being met. LPA Bunker contacted Inglewood Police Department and spoke to Officer Shein #1038 their findings were unsubstantiated. LPA Bunker also, called Logix Federal Credit Union and was unable to obtain any information regarding the allegation. Staff and residents denied allegation.

Based on interviews, available evidence, observation, information received, and records reviewed there was not enough sufficient evidence to support the allegation. 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 deemed unsubstantiated.

LPA Bunker emailed Administrator Delores Davis a hard copy via email for signature of the Complaint Investigation Report LIC9099 and LIC9099-C.

A telephonic exit interview was conducted.

SUPERVISOR'S NAME: Michael Cava	TELEPHONE: (323) 400-7397
LICENSING EVALUATOR NAME: Pamela Bunker	TELEPHONE: (323) 213-1113
LICENSING EVALUATOR SIGNATURE:	DATE: 09/04/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/04/2020

LIC9099 (FAS) - (06/04)

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