198603031-1-9-2024-11-AS-SCIS-D55R3B-20240510123937

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603031
Report Date: 01/05/2024
Date Signed: 01/09/2024 12:16:20 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/28/2023 and conducted by Evaluator Pamela Bunker

COMPLAINT CONTROL NUMBER: 11-AS-20231228112344

FACILITY NAME:	ANZAC RESIDENTIAL CARE		FACILITY NUMBER:	198603031
ADMINISTRATOR:	ROBINSON, ANDREA		FACILITY TYPE:	735
ADDRESS:	12323 S ANZAC AVE		TELEPHONE:	(310) 901-5428
CITY:	COMPTON	STATE: CA	ZIP CODE:	90222
CAPACITY:	6	CENSUS: 5	DATE:	01/05/2024
		UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Andrea Robinson		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Facility staff did not arrange for appropriate transportation services for a resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Pamela Bunker conducted an unannounced complaint visit on Friday, January 05, 2024, Upon arrival at the facility. LPA Bunker called the facility via telephone and conducted a Risk Assessment. Based on the assessment, the facility is cleared of COVID-19 infection. LPA Bunker met with Licensee Andrea Robinson. LPA Bunker explained the purpose of today's visit.

The investigation consisted of the following: LPA Bunker conducted interviews with staff members S1 and S2, as well as residents R1 through R5, to address the alleged complaint allegation: Facility staff did not arrange for appropriate transportation services for a resident. Both staff members and residents consistently reported that the facility ensures adequate supervision to all residents, with staff presence at all times. Both S1-S2 affirmed that residents receive necessary care and assistance with their daily needs, along with regular communication about their care and supervision. Both S1-S2 clarified that at no point did a resident wait unsupervised for seven hours, as staff were always present at the facility.
See continued LIC9099-C page 2

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2024

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 11-AS-20231228112344

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: ANZAC RESIDENTIAL CARE	FACILITY NUMBER: 198603031
	VISIT DATE: 01/05/2024

NARRATIVE

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Continued LIC9099-C page 2

Both S1-S2 emphasized the facility's commitment to providing 24/7 care throughout the year. Regarding S1's attendance at a funeral, a copy of the obituary was provided for verification. S1 also noted that during this time, arrangements were made to ensure continuous care, offering to leave the funeral, if needed, to facilitate the resident’s return from the hospital or to have the resident transported back to the facility by someone else. S1-S2 reiterated staff presence at the facility during this period.
LPA Bunker requested copies of supporting documents.

Investigation revealed the following: In the conducted interviews with staff members S1 and S2, as well as residents R1 through R5, it was unequivocally established that at no time was there an incident of a resident waiting unattended for seven hours. Both staff and residents attested to the fact that the facility is manned 24 hours a day, seven days a week, throughout the year, ensuring continuous and adequate supervision. The consensus among those interviewed is that residents consistently receive the necessary care and oversight.

Regarding the specific incident at St. Francis Medical Center, staff member S1 explained that it represented a significant misinterpretation of events. S1 confirmed that arrangements for suitable transportation services for the resident in question were indeed made. This response was prompted by an inquiry from the facility's Social Worker, to which S1 assured the timely and safe return of the resident to the facility. S1 expressed surprise and concern over the filing of a complaint, as no issues regarding the resident were reported or observed. Both S1-S2, along with residents R1 through R5, consistently validate the unwavering presence of staff members at the facility, ensuring ongoing care and supervision. In light of these testimonies, S1-S2 categorically refute any allegations of neglect pertaining to this matter.

Based on interviews, available evidence, observation, information received, and records reviewed there was not enough sufficient evidence to support the allegation. 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 deemed unsubstantiated.

A copy of the Complaint Investigation Report LIC9099 & LIC9099-C was provided to Licensee Andrea Robinson. There were no deficiencies cited. An exit interview was conducted.

SUPERVISORS NAME: Stephanie Cifuentes
LICENSING EVALUATOR NAME: Pamela Bunker
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2024

LIC9099 (FAS) - (06/04)

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