198602608-1-18-2024-28-AS-LHIS-CZQS97-20240122124017

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602608
Report Date: 01/18/2024
Date Signed: 01/18/2024 02:34:14 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
12/19/2023 and conducted by Evaluator Alberto Lopez

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20231219092627

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: 134	DATE:	01/18/2024
		UNANNOUNCED	TIME BEGAN:	09:46 AM
MET WITH:	Laura Rodriguez Executive Director		TIME COMPLETED:	02:47 PM

ALLEGATION(S):

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Staff do not maintain facility at a comfortable temperature for resident

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Alberto Lopez made an unannounced subsequent complaint investigation regarding the above allegation. LPA met with Laura Rodriguez Executive Director and explained the reason for the visit.

During the visit, LPA Lopez conducted a tour of the facility with Executive Director Laura Rodriguez. LPA Lopez interviewed Executive Director S1, 4 staff S2 through S5 and total of thirteen (13) residents who shall be referred to as R1 through R13. LPA Lopez obtained staff roster, resident roster, one (1) month of work orders, Report from specialty A/C and heat dated 12/01/2023 R1’s physician report, referral for R1 to Physician dated 12/23/2023. LPA took photos of the thermostats in the facility common areas and random rooms.

(Continued on 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Alberto Lopez	TELEPHONE: 323-980-4926
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024

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-20231219092627

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: IVY PARK AT CERRITOS	FACILITY NUMBER: 198602608
	VISIT DATE: 01/18/2024

NARRATIVE

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The investigation revealed:

Allegation: Staff do not maintain facility at a comfortable temperature for resident. It is alleged that resident did not have heat for over a week, that it is 69 degrees F in R1 room.

LPA interviewed 5 total staff including 2 maintenance technicians and 5 of 5 staff denied the allegation. The technicians stated that the have had many work orders due to R1 complaining about the temperature in R1 room and that after inspecting the room, it has been confirmed that R1 thermostat is functioning properly. The facility also provided 2 portable heaters to provide R1 with alternative heat due to R1 insisting that R1 room heat is not working and alleging that is it blowing cold air. LPA was in R1 room for some time measuring the temperature in R1 room. The temperature was 82 degrees at the time of measurement and felt warmer than that to LPA. LPA did not notice or feel any cold air coming from the vent as alleged. LPA checked temperatures throughout the facility, and it measured 72.8 degrees in the facility sample room #145. It was 75.3 degrees in hallway adjacent to room 117. LPA along with Laura Rodriguez Executive Director checked the temperatures in rooms 116, 117,119,123, 125, 120, 127, 129, and 246 and they measured between 73.9 degrees F to 78.0 degrees F which is within regulatory range. LPA interviewed 13 residents and 13 of 13 could not collaborate the allegation. Mostly all the residents stated that the temperature in the rooms are comfortable, and they have no complaints. 2 residents stated that the cold goes through the window in their rooms, but stated the room is comfortable. One resident stated the heat goes through the window in room. LPA suggested to Laura Rodriguez Executive Director to follow up with the 3 residents’ window issues to check if windows have failed. LPA tested the thermostat in R1 room, and it was operating properly. R1 had stated that one of R1 portable heaters was not working. LPA, Laura Rodriguez Executive Director, and S2 verified that it was working and S2 instructed R1 on how to operate it. On initial visit on 12/22/2023, LPA suggested that facility make R1 physician aware of R1 concerns about feeling very cold most of the time while in R1 room. Facility did follow-up with R1 physician right away and tests were order and results pending. LPA obtained invoice from Specialty A/C that confirms that the A/C-Heating unit in room 117 is working properly. Facility has also offered to move R1 but R1 refused. LPA did not find any evidence to substantiate the allegation.

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) 981-3972
LICENSING EVALUATOR NAME: Alberto Lopez	TELEPHONE: 323-980-4926
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2024

LIC9099 (FAS) - (06/04)

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