198602608-4-18-2022-28-AS-WSHO-CECUAG-20220512152442

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198602608
Report Date: 04/18/2022
Date Signed: 04/18/2022 10:52:52 AM

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
02/03/2022 and conducted by Evaluator Nune Margaryan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20220203110548

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: 128	DATE:	04/18/2022
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Business Manager Carmen Galicia		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Food service is inadequate.
Resident is not provided privacy.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nune Margaryan conducted a subsequent complaint visit to complete the investigation and deliver findings for the allegations listed above. LPA met with Business Manager Carmen Galicia and explain the purpose for today’s visit.

The initial visit was conducted by LPA Nune Margaryan on 02/11/22 . During the visit, LPA Nune Margaryan interviewed the Business Manager, Staff #1-4 (S1-S4), and Residents #1-14 (R1-R14). LPA also collected a copies of the staff roster, resident roster, menus for residents food.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3378
LICENSING EVALUATOR NAME: Nune Margaryan	TELEPHONE: 323-981-3378
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2022

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-20220203110548

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: 04/18/2022

NARRATIVE

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The investigation revealed the following:
Food service is inadequate. It was alleged that Resident#1 (R1) has had problem with food.
LPA interviewed Business Manager and Staff #1-4 (S1 - S4), Resident #1-14 (R1 - R14). R1 and all other interviewed residents denied the allegation and reported the food service is adequate. There's plenty of food for them to choose. They can get as much as they want. Residents stated they are given a menu with different options to choose. R1 was interviewed in the dinning room and had no complaints that food service is inadequate. R1 stated that she likes to eat at the dining room but trying to keep her distance from other residents and staff because of Covid - 19. Also, R1 indicated that residents can request room service. Interviews with Business Manager and staff revealed that the facility does provide residents adequate food service. Business Manager stated didn’t hear any complaints that food service is inadequate. Residents can always get second and they can choose the substitute food if they do not like the menu of the day. Interviewed staff stated if residents wanted more food, they would be provided with more food. Also, residents were served food in their rooms by their request. LPA reviewed facility's menus which contains a variety of foods for each meal covering all food groups.

Resident is not provided privacy. It was alleged that Resident#1 (R1) can not rest, sleep and eat without interruptions from staff. LPA interviewed Business Manager, Staff #1-4 (S1 - S4), Resident #1-14 (R1 - R14).. Business Manager stated that staff always provided privacy to residents. All residents can rest, sleep and eat without interruptions from staff. Staff will not enter the residents room without their consents. Usually residents eat in the dining room, but also food can be served in their rooms. And staff will always knock on the door before entering their rooms to serve the food. Staff will wait until residents responds before entering. Interviewed staff denied the allegation. They didn’t hear any complaints from any residents regarding this allegation. They stated that they always knock before walking into residents rooms and never interrupt residents while they are resting, sleeping or eating. Interviewed residents indicated they have their own private room and staff give them their privacy.

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SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3378
LICENSING EVALUATOR NAME: Nune Margaryan	TELEPHONE: 323-981-3378
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2022

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20220203110548

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: 04/18/2022

NARRATIVE

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Residents interviews revealed that they have not heard anyone expressing concern about residents not given privacy nor staff entering their room without consent. Staff knock on the door and wait to be called in before entering their rooms. Staff and client interviews do not corroborate this allegation.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

An exit interview was conducted, a copy of the report and appeal rights were provided to Business Manager

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3378
LICENSING EVALUATOR NAME: Nune Margaryan	TELEPHONE: 323-981-3378
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2022

LIC9099 (FAS) - (06/04)

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