198602608-2-21-2023-28-AS-MVAO-CPGSMX-20230228130037

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602608
Report Date: 02/21/2023
Date Signed: 02/21/2023 04:27:35 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
02/11/2022 and conducted by Evaluator Kimberly Ramirez

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20220211102513

FACILITY NAME:	GROVE AT CERRITOS, THE		FACILITY NUMBER:	198602608
ADMINISTRATOR:	BRITTNEY BUCHANNAN		FACILITY TYPE:	740
ADDRESS:	11000 NEW FALCON WAY		TELEPHONE:	(562) 865-9500
CITY:	CERRITOS	STATE: CA	ZIP CODE:	90703
CAPACITY:	163	CENSUS: 130	DATE:	02/21/2023
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Carmen Hernandez		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Residents air conditioner is in disrepair.
Staff is not serving food timely.
Staff is putting chemicals in the water that residents utilize.
Facility toaster in disrepair.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kimberly Ramirez conducted a subsequent complaint visit stemming from initial 10-day complaint visit on 02/17/2022. LPA was met by Staff (S1) and explained the purpose of the visit.
The investigation consisted of the following: An inspection of the interior and exterior physical plant was conducted. Staff (S1-S6) and residents (R1- R6) were interviewed. Resident (R1) was not present, and LPA attempted to interview telephonically. LPA requested and obtained the following documents: LIC 500 Personnel Report, Resident roster, Invoices for A/C and heating repair, and invoices for toaster appliance.

See LIC 9099C for report continuation.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Tony Vasallo	TELEPHONE: (323) 981-3977
LICENSING EVALUATOR NAME: Kimberly Ramirez	TELEPHONE: (323) 981-3970
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023

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-20220211102513

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: 02/21/2023

NARRATIVE

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Allegation: Residents air conditioner is in disrepair. It is alleged that the air conditioner was not working properly even after staff allegedly fixed the air conditioner. All Staff (S1-S6) all deny this allegation and five (5) out of six (6) residents interviewed all deny this allegation. Resident (R2) stated” I’ve never had problems with the air conditioner or heating here. I control the temperature, if not, I would have told them and they fix it.” Staff (S2) stated “If there’s a work order for the air conditioner or heater, I go to the room and try to trouble shoot it. If we can’t fix it by trouble shooting, we will call the company that fixes our central a/c and heating to come out.” At 10:07 am, LPA and S1 toured room #117 to observe and test air conditioner/ heater. LPA observed thermostat located directly on right side of door entry to read 72 degrees F. S1 turned on air conditioner by setting desired temperature to 65 degrees F. LPA observed a green light appear on thermostat and could audible hear air being pushed through vent located direct above where LPA was standing. LPA let air conditioner run for 3 mins and could feel cold air coming down from vent above where LPA was standing. LPA observed vent dust overs directly under two (2) out of three vents. Per S1, resident R1 requested to have these installed as to “push heat up and not directly down on resident.” S1 then turned off air conditioner and ran heater for 3 mins. LPA observed a green light display on thermostat and feel heat being pushed from vent and circulating in room. LPA reviewed an invoice from December of 2021 that indicates air conditioner/heater was replaced in room #117 and in January of 2023, a control board was replaced in this accommodation. LPA reviewed work order logs for room #117 from 11/2022 till 02/2023, indicated most request for air conditioning/ heating service, were due to user error.

Allegation: Staff is not serving food in a timely manner. It is alleged staff brings out meals late for dinner service. Six (6) out of six (6) staff interviewed deny this allegation. Five (5) out of (5) residents interviewed deny this allegation. Staff S1 stated “All our food is cooked to order. We sit them down and they wait for a few minutes and sometimes that’s too long for them. We are currently working on a POS system that will eliminate taking orders by hand. Staff will take orders on a tablet, and they will go directly to the kitchen. We are currently training staff on how to use it and it should be rolled out by March 2023.” Resident R3 stated “When I order my food in the dining hall, they bring it pretty fast. Sometimes I wait but that is like any restaurant. I like the food. It taste pretty good.” LPA observed the dining hall around 9:46 am. LPA observed two (2) servers taking food orders and one (1) host during this time. LPA observed a nearby resident order breakfast from menu and observed a server bring out breakfast dish within 8 minutes.

SEE 9099-C

SUPERVISOR'S NAME: Tony Vasallo	TELEPHONE: (323) 981-3977
LICENSING EVALUATOR NAME: Kimberly Ramirez	TELEPHONE: (323) 981-3970
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20220211102513

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: 02/21/2023

NARRATIVE

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Allegation: Staff is putting chemicals in the water that residents utilize. It is alleged that staff is putting bleach and CLR in the drinking water and they are using this water to prepare meals. Six (6) out of six (6) staff interviewed deny this allegation. Five (5) out of (5) residents interviewed deny this allegation. At 9:51 am, LPA observed beverage station, located in kitchen area. LPA observed two (2) locations in the beverage station area that is designated for staff to retrieve water for consumption and cooking. LPA observed several kitchen staff filling pitchers of water from beverage station faucet located in between coffee dispenser and microwave. Second water station is a soft drink beverage dispenser located next to coffee dispenser. At 10:34 am, LPA observed cleaning supplies like bleach and CLR, to be secured and inaccessible to residents; in the House Keeping room, which is not near kitchen area. At 10:38 am, LPA did observe bleach products near a kitchen sink that is marked for “hand washing only” and did not observe any food being prepared or served near this area.

Allegation: Facility toaster in disrepair. It is alleged that the toaster is not working and resident is unable to have toast during breakfast. Six (6) out of six (6) staff interviewed deny this allegation. Five (5) out of (5) residents interviewed deny this allegation. At 9:48 am. LPA observed a Countertop Conveyor Oven that was toasting 3 slices of bread. Per S1, “The toaster was replaced about a year ago because the button was messed up, but it was still functioning.” Resident R2 stated “The toast is good. I have not ever heard of it being broken.”

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

An exit interview was conducted with Staff S1. A copy of the report was issued.

SUPERVISOR'S NAME: Tony Vasallo	TELEPHONE: (323) 981-3977
LICENSING EVALUATOR NAME: Kimberly Ramirez	TELEPHONE: (323) 981-3970
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2023

LIC9099 (FAS) - (06/04)

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