198602608-10-21-2022-28-AS-RORN-CKHV8B-20221024161227

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602608
Report Date: 10/17/2022
Date Signed: 10/21/2022 01:54:13 PM

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
10/03/2022 and conducted by Evaluator Bennette Pena

COMPLAINT CONTROL NUMBER: 28-AS-20221003120259

FACILITY NAME:	GROVE AT CERRITOS, THE		FACILITY NUMBER:	198602608
ADMINISTRATOR:	LILIT CHAPARYAN		FACILITY TYPE:	740
ADDRESS:	11000 NEW FALCON WAY		TELEPHONE:	(562) 865-9500
CITY:	CERRITOS	STATE: CA	ZIP CODE:	90703
CAPACITY:	163	CENSUS: 132	DATE:	10/17/2022
		UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Business Office Director, Nicole Reyes		TIME COMPLETED:	11:35 AM

ALLEGATION(S):

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Staff are not maintaining a comfortable room temperature for resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Bennette Pena conducted a subsequent visit to investigate the above allegation. LPA met with Business Office Director, Nicole Reyes and explained the purpose of today's visit.

During the initial visit on 10/10/2022, LPA obtained a copy of the staff/resident roster, work order for the A/C unit and Resident #1 (R1) file, interviewed Resident #1-#4 (R1-R4), Staff #1-3 (S1-3). LPA conducted a tour of the facility which included the front entrance, common areas, hallways, inspected (9) resident rooms (Rooms #103, #108, #112, #114, #115, #117, #123, #127 and #129) and verified thermostat readings.The temperature readings were between 78-80 deg. F which is within Title 22 Regulations. LPA requested copies of the maintenance log for the last 3 months to be sent to LPA's email by end of the business day on 10/11/2022.

During today’s visit, LPA continued the interviews with Resident #5-13 (R5-R13), Staff #4-5 (S4-S5), reviewed service reports and work order details from A/C & Heating vendor between Dec. 2021 – Sep. 2022.
*****REPORT CONTINUED ON LIC 9099-C*****

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: David Sicairos	TELEPHONE: (323) 981-3982
LICENSING EVALUATOR NAME: Bennette Pena	TELEPHONE: (323) 981-3307
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2022

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-20221003120259

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: GROVE AT CERRITOS, THE	FACILITY NUMBER: 198602608
	VISIT DATE: 10/17/2022

NARRATIVE

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Allegation: Staff are not maintaining a comfortable room temperature for resident

During this investigation, LPA conducted a tour of the facility, interviewed Resident #1 through Resident #13 (R1-R13) and Staff #1 through Staff #5 (S1-S5). Twelve (12) out of thirteen (13) interviewed residents indicated that temperature in their rooms and in the common areas of the facility is comfortable. Twelve (12) residents indicated that their individual air/heating unit is working in their rooms. Eight (8) of the residents indicated that they know how to operate the thermostat and can adjust the temperature. Five (5) residents do not know how to operate thermostat, but maintenance staff assist them to adjust the temperature to their liking. According to the staff interviews, S1-5, the facility maintains comfortable temperature for residents. S1, S4-5 indicated that the complaint they are aware of regarding the heating and air unit not working is R1. S2-3 stated they get calls from R1 to complain about the a/c & heating unit not working. S2-3 responded to R1's calls and adjust the thermostat. S1 offered R1 to move to a different room if she likes but R1 refused. S4-5 stated that they are not aware of other complaints regarding the a/c and heating unit except R1. Both indicated that they did their due diligence in attending to R1's needs. The records review revealed that R1 has sent multiple requests to fix her heating/air unit to the maintenance staff and their findings resulted in the unit working correctly. S1, S4-5 stated that they showed R1 how to operate the thermostat many times. S1 also provided R1 an instruction/guide on how to operate the thermostat. LPA’s review of the reports for the services performed (2/4/22, 6/28/22 & 9/14/22) from the facility’s vendor indicated that the technician’s findings also resulted in the unit working correctly and the refrigerant levels in the system are adequate. LPA observed that R1’s room temperature was at 78 deg F (at 10am on 10/10/22) which is within Title 22 regulation. LPA also observed that the temperature reading for the common areas and other residents’ rooms were between 78-80 deg F which is within Title 22 regulations. Documentation reviewed, observations and interviews conducted do not corroborate this allegation.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview, a copy of this report was provided to the Business Office Director, Nicole Reyes.

SUPERVISOR'S NAME: David Sicairos	TELEPHONE: (323) 981-3982
LICENSING EVALUATOR NAME: Bennette Pena	TELEPHONE: (323) 981-3307
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2022

LIC9099 (FAS) - (06/04)

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