198602608-11-18-2020-28-AS-MVAO-BX8RSV-20210113121724

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602608
Report Date: 11/10/2020
Date Signed: 11/18/2020 07:48:45 AM

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 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
04/21/2020 and conducted by Evaluator Renee Arterberry

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20200421120138

FACILITY NAME:	GROVE AT CERRITOS, THE		FACILITY NUMBER:	198602608
ADMINISTRATOR:	CRENSHAW, CAMILLE		FACILITY TYPE:	740
ADDRESS:	11000 NEW FALCON WAY		TELEPHONE:	(562) 865-9500
CITY:	CERRITOS	STATE: CA	ZIP CODE:	90703
CAPACITY:	163	CENSUS: 132	DATE:	11/10/2020
		UNANNOUNCED	TIME BEGAN:	11:37 AM
MET WITH:	Krystal Jenkins, administrator		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff denied resident visitation

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ren’ee Arterberry initiated a Complaint Follow-Up Visit to investigate the allegation noted above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19) and to implement mitigation measures today's complaint investigation was conducted telephonically with administrator Krystal Jenkins and the allegation noted above was discussed.

The investigation consisted of the following: on 04/29/2020 LPA Ira requested copies of: Resident Roster (current) and staff rosters (current with contact information), a list of Residents that have relocated (for February 2020, March 2020 and April 2020) along with their contact information, visitation policy (prior COVID-19), current visitation policy and a list of residents/visitors that expressed concern about visitation procedures. LPA Arterberry acknowledge receiving the documents noted above. During the course of this visit the LPA randomly selected and interviewed a total of six (6) staff and they shall be referred to as, S1 (the administrator, S1), S2, S3, S4, S5 and S6. The LPA also randomly selected and interviewed a total of ten (10) residents and they shall be referred to as, R1, R2, R3, R4, R5, R6, R7, R8, R9 and R10.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Renee Arterberry	TELEPHONE: (323) 981-3342
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2020

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 28-AS-20200421120138

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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: GROVE AT CERRITOS, THE	FACILITY NUMBER: 198602608
	VISIT DATE: 11/10/2020

NARRATIVE

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The investigation reveal the following: it is alleged, that on 1/27/20 an individual who shall be referred to as V1 was denied visitation by a staff member who shall be referred to as S7. The administrator state, it is the facility policy to instruct all visitors to sign the facility Visitation Sheet located in the reception area. In April of this year the facility administration developed a Coronavirus Visitation Policy. Although, non-essential visits were restricted, essential visitors were allowed. The facility administrator conducted a meeting with all staff instructing them to allow visitation of essential workers. The administrator denied instructing staff to deny entry/visitation of essential workers. In addition, if the Visitation Sheet/chart is missing the staff are instructed to use another sheet. The staff state that they were instructed not to deny visitation of essential visitors. The staff also deny overhearing or being told that other staff are denying or have denied visitation by essential workers. In addition, the staff also state that if the Visitation Sheet/Chart is missing, they use another sheet but do not deny visitation because the Visitation Sheet/Chart is missing.

All residents state that in March and April of this year, "in person" visitations of non-essential workers were discouraged. However, alternative forms of visits were encouraged: Zoom, Skype and FaceTime. In April, the administration conducted a meeting with the residents to discuss the virus and the Coronvirus Visitation Policy. A majority of the residents also state that they received visits by essential workers in March and April. None of the residents state that visitations of essential workers were denied in April or March. The residents deny being told by staff that essential workers were not allowed to visit. A review of the visitation policy (prior COVID-19), page 29, "the community (it is understood they are referring to the facility) is operated on a non-discriminatory basis and affords equal treatment. The community does not discriminate and does not permit discrimination".

A review of the Coronavirus Policy Update 03/28/20 reveal that the definition of "essential workers" are defined as: medical professionals, pharmacy consultants, private duty care providers, Adult Protective Services and end of life/clergy . All SRG communities are to immediately follow any specific Federal, State and or County regulations and submit the regulations to the Corporate Director of Health and Quality Services.

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Renee Arterberry	TELEPHONE: (323) 981-3342
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2020

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 28-AS-20200421120138

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 CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: GROVE AT CERRITOS, THE	FACILITY NUMBER: 198602608
	VISIT DATE: 11/10/2020

NARRATIVE

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The prior visitation policy is in accordance with California Code of Regulations Title 22. The Coronavirus Policy are in accordance with guideline provided by Department of Public Health.

Ten (10) residents were interviewed. The administrator and five (5) staff were also interviewed. The Visitation Policy prior to COVID-19 and Post Coronavirus Visitation Policy were reviewed. In March, the administrator instructed staff on the Coronavirus Visitation Policy and to allow entry to all essential workers. The staff acknowledged the administrator instructed them to allow visitation of all essential workers. The staff denied being instructed by administration to deny visitation of essential workers. A majority of the residents state that they received visits by essential workers in April and May. The residents state that they were not denied visitation by essential workers. It shall be noted, S7 is no longer employed by The Grove at Cerritos affective 02/19/2020.

Based on the evidence, interviews conducted and documents reviewed the finding is unsubstantiated. 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 complaint investigation of the allegation is unsubstantiated.

No Deficiencies cited under California Code of Regulations Title 22

An exit Interview was conducted via telephone with the administrator and a hardcopy was provided via email for signature. Signatures on hardcopies.

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Renee Arterberry	TELEPHONE: (323) 981-3342
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2020

LIC9099 (FAS) - (06/04)

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