198602413-6-4-2023-11-AS-MVAO-CTFV6Q-20230705160955

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602413
Report Date: 06/04/2023
Date Signed: 06/04/2023 02:14:53 PM

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
02/15/2023 and conducted by Evaluator Ana Soto

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20230215144012

FACILITY NAME:	LA'DELIA RESIDENTIAL HOME		FACILITY NUMBER:	198602413
ADMINISTRATOR:	OIKHALA, PERPETUAL		FACILITY TYPE:	735
ADDRESS:	7023 DENVER AVE		TELEPHONE:	(323) 305-1971
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90044
CAPACITY:	4	CENSUS: 4	DATE:	06/04/2023
		UNANNOUNCED	TIME BEGAN:	12:20 PM
MET WITH:	Jennifer Oti, Care giver		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Untrained staff are providing care to residents.
Facility has rodents.
Facility has bed bugs.
Licensee does accord resident(s) in care dignity.
Licensee does not allow resident in care access to their belongings.
Food services are inadequate.
Facility is in disrepair.
Unqualified staff are administering medications to residents in care.
Licensee did not allow resident to purchase a cell phone for personal use.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ana Soto conducted a subsequent complaint investigation to deliver findings and decisions for the allegations listed above. Today’s complaint investigation was conducted with Jennifer Oti, Care giver

The investigation consisted of following: Interviews and Record reviews. On 02/23/23, LPA Soto conducted interviews with Administrator & S#2, C#1 & C#2. Toured the entire facility inside and out, Inspected the food supply & observed food preparation for dinner, cabinets, Rooms #1 -#3, living room, dining room, bathrooms, and garage. Observed inter-action between staff and C#1. LPA also requested copies of the following documents: Resident Roster, Staff Roster, Menu, Staff trainings for S#1 - S#5, C#1 - C#3 - Mars (February) - P&I Logs. On 06/04/23, LPA requested and received copy of Physicians report for C#1 & C#2.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ana Soto
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 3

Control Number 11-AS-20230215144012

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: LA'DELIA RESIDENTIAL HOME	FACILITY NUMBER: 198602413
	VISIT DATE: 06/04/2023

NARRATIVE

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Based on the LPA's investigation, the investigation revealed the following.

For Allegation 1 - Untrained staff are providing care to residents. Interviews conducted with Staff, communicated that they are trained to take care of the clients. The staff care for and get along with the clients. They always meet the client’s needs; they get all the care they need. Clients could not communicate with LPA, they were nonverbal. LPA reviewed staff’s training's records and staff had all the required training to be a care giver. The interviews and records did not concur with the above allegation.

Allegation 2 - Facility has rodents. Interviews conducted with Staff, communicated that they have never had any type of rodents at the facility. If they ever did have rodents, they would let administrator know to have someone come and get rid of them. Clients could not communicate with LPA, they were nonverbal. LPA inspected the entire facility and LPA did not observe rodents, rodents’ feces, ants and/or cockroaches. The interviews and observations did not concur with the above allegation.

Allegation 3 - Facility has bed bugs. Interviews conducted with Staff, communicated that they have never been any bed bugs at the facility. If they ever did, they would let administrator know to have someone come and get rid of them. Clients could not communicate with LPA, they were nonverbal. LPA inspected the clients’ bedrooms; beds and furnisher, LPA did not observe any bed bugs or bed bugs feces. The interviews and observations did not concur with the above allegation.

Allegation 4 - Licensee does accord resident(s) in care dignity. Interviews conducted with Staff, communicated that they always respect the clients and treat them with dignity. Clients could not communicate with LPA, they were nonverbal. LPA observed staff’s inter-action with C#1. C#1 seemed happy and was playing with the staff. The interviews and observations did not concur with the above allegation.

Allegation 5 - Licensee does not allow resident in care access to their belongings. Interviews conducted with Staff, communicated that they never take or steal any of the clients belonging. They would never do anything like that to the clients, they love their clients. Clients could not communicate with LPA, they were nonverbal. LPA inspected clients’ rooms, LPA reviewed the clients’ belongings forms and the rooms by LPA observation the clients had their belongings. The interviews and observations did not concur with the above allegation.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ana Soto
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 11-AS-20230215144012

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: LA'DELIA RESIDENTIAL HOME	FACILITY NUMBER: 198602413
	VISIT DATE: 06/04/2023

NARRATIVE

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Allegation 6 - Food services are inadequate. Interviews conducted with Staff, communicated that they cook different foods for the clients, they love the food. The menu has healthy and variety of food. Clients could not communicate with LPA, they were nonverbal. LPA reviewed the facility menus; they have a variety of food and healthy food choices. They vary the menu weekly; they do not recycle the same menus every week. The interviews and records reviewed did not concur with the above allegation.

Allegation 7 - Facility is in disrepair. Interviews conducted with Staff, communicated that they facility is in good repair, nothing broken. Everything works at the facility. Clients could not communicate with LPA, they were nonverbal. LPA toured the entire facility; LPA did not observe anything that needed any repairs and/or to be replace. The interviews and observations did not concur with the above allegation.

Allegation 8 - Unqualified staff are administering medications to residents in care. Interviews conducted with Staff, communicated that they are trained to give medication to the clients. Clients could not communicate with LPA, they were nonverbal. LPA reviewed staff’s training's records and staff had all the required training to give medication. The interviews and records did not concur with the above allegation.

Allegation 9 - Licensee did not allow resident to purchase a cell phone for personal use. Interviews conducted with Staff, communicated that all the clients can have cell phones, but 2 clients can’t operate them, so the staff calls for them with the facility phone. One client has a phone and uses it all the time. Clients could not communicate with LPA, they were nonverbal. LPA observed the facility phone working and reviewed the clients physician’s reports dated 02/17/21 & 06/08/21. Client’s mental conditions do not allow them to properly operate a cell phone. The interviews and record reviews did not concur with the above 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 with Jennifer Oti, Care giver, and a hard copy of report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ana Soto
LICENSING EVALUATOR SIGNATURE:	DATE: 06/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2023

LIC9099 (FAS) - (06/04)

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