198602608-12-4-2023-28-AS-LHIS-CZJKVZ-20240116071507

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602608
Report Date: 12/04/2023
Date Signed: 12/04/2023 12:32:18 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 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
11/21/2023 and conducted by Evaluator Jewel Baptiste

COMPLAINT CONTROL NUMBER: 28-AS-20231121100332

FACILITY NAME:	IVY PARK AT CERRITOS		FACILITY NUMBER:	198602608
ADMINISTRATOR:	LAURA RODRIGUEZ		FACILITY TYPE:	740
ADDRESS:	11000 NEW FALCON WAY		TELEPHONE:	(562) 865-9500
CITY:	CERRITOS	STATE: CA	ZIP CODE:	90703
CAPACITY:	163	CENSUS: 113	DATE:	12/04/2023
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Executive Director Laura Hernandez		TIME COMPLETED:	12:40 PM

ALLEGATION(S):

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Staff are not maintaining a comfortable room temperature for resident.

INVESTIGATION FINDINGS:

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On 12/04/2023 at 08:00 a.m., Licensing Program Analyst(s) (LPA) Jewel Baptiste and Sanjay Vaid conducted an unannounced subsequent complaint investigation regarding the above allegation(s). LPAs met with Laura Rodriguez Executive Director and explained the reason for the visit.

During the visit on 11/30/2023, LPA Baptiste conducted a tour of the facility. LPA checked the thermostat in rooms #117,163,179,201, 210, 219, and 227 with Executive Director Laura Rodriguez. LPA Baptiste interviewed Executive Director and a total of five (5) residents who shall be referred to as R1 through R5. LPA Baptiste obtained staff roster, resident roster, one (1) month of work orders, Ontario Refrigeration dated 6/9/2023, Report from specialty A/C and heat dated 11/28/2023, R1’s physician report, and photos from Executive Director regarding the thermostat in room#117. LPA took photos of the thermostats in the facility common areas.
Report Continued on 9099c

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 213-1556
LICENSING EVALUATOR NAME: Jewel Baptiste	TELEPHONE: (323) 400-9594
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2023

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-20231121100332

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: IVY PARK AT CERRITOS	FACILITY NUMBER: 198602608
	VISIT DATE: 12/04/2023

NARRATIVE

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The investigation reveals the following: Regarding “Staff are not maintaining a comfortable room temperature for resident”. It is alleged that R1’s room is very hot in the summer and very cold during the winter. The Executive Director denied the allegation stating each resident have an individual unit that they can control, if the A/C unit is not working the resident can put in a work order and received a portable unit if needed. The Executive Director further stated R1’s A/C unit is operational and has been inspected by two (2) A/C companies who found no issues. 2 out of 2 staff denied the allegation stating all the A/C units work and they respond right away. 10 out of 13 residents stated their system work and they call for assistance whenever they want to change it. 1 out of 13 residents stated their A/C unit is not working but was given portable A/C unit until the repairs are made. 1 out of 13 residents stated their A/C unit is not operational. LPA’s reviewed A/C invoices and confirmed the A/C units are operating normally.

Based on LPA's interviews, observation, and file review the investigation revealed that 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 UNSUBSTANTIATED.

Exit interview was conducted with Laura Rodriguez Executive Director and a copy of this report was provided.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 213-1556
LICENSING EVALUATOR NAME: Jewel Baptiste	TELEPHONE: (323) 400-9594
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2023

LIC9099 (FAS) - (06/04)

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