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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603162
Report Date: 12/27/2021
Date Signed: 12/27/2021 02:29:56 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
12/20/2021 and conducted by Evaluator Christine Wong
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20211220120618
FACILITY NAME:WHITTIER GLEN ASSISTED LIVINGFACILITY NUMBER:
198603162
ADMINISTRATOR:ATEAIAN, KIMIAFACILITY TYPE:
740
ADDRESS:10615 JORDAN RDTELEPHONE:
(562) 943-3724
CITY:WHITTIERSTATE: CAZIP CODE:
90603
CAPACITY:93CENSUS: 55DATE:
12/27/2021
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Sophia Chan-Executive DirectorTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Requests for assistance are not being responded to in a timely manner
Residents in wheelchairs are blocking facility exitway.
Facility is cold
Resident was not provided medication in a timely manner.
Food not being prepared in a safe manner.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christine Wong conducted an unannounced complaint visit to address the above allegations and met with Caregiver-Tanya Ramos and explained the reason of the visit. At around 10:00am, the Executive Director- Sophia Chan arrived and assist with the visit.

The investigation consisted of the following: LPA toured the facility and interviewed six (6) residents, executive director and six (6) staff and obtained copy of the resident and staff rosters.

The investigation revealed of the following: Allegation#1 "Requests for assistance are not being responded to in a timely manner. " LPA interviewed six (6) residents and five (5) residents stated that the staff responded quick and it usually takes about couple minutes for them to come and assist them. LPA interviewed the staff and all denied the allegation. The executive director reported it would never happened or acceptable for a resident to wait for an hour for asssitance.
(See LIC 9099C for Continuation)
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Christine Yee
NAME OF LICENSING PROGRAM ANALYST: Christine Wong
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/27/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 28-AS-20211220120618
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: WHITTIER GLEN ASSISTED LIVING
FACILITY NUMBER: 198603162
VISIT DATE: 12/27/2021
NARRATIVE
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Executive Director also stated that currently the facility had some issues with the security system for the pendant. After the pendent was cleared, it would ring again or even the resident was not present in the facility and the pendent would ring itself too. The facility is in the process of fixing it and contacting another company for a new system.

Allegation#2 "Residents in wheelchairs are blocking facility exit way." LPA interviewed six (6) residents and all denied the allegation and stated that not seeing any residents in wheelchairs are blocking the exit way. LPA also interviewed staff and all denied the allegation too and reported only sometimes when residents with walker are lining up to the dining room for lunch, it may be crowded there but staff usually would monitor and ensure the residents are standing on the side way and not blocking the entrance or the exit way. LPA observed the situation only happened around lunch time but the staff did step up and monitor the entrance or exit way were not blocked.

Allegation#3 "Facility is cold. " LPA interviewed six (6) residents and four (4) residents reported they do not feel the facility or their rooms are cold. LPA interviewed the staff and denied the allegation. The executive director reported the facility thermostat are usually set between 71.5 to 72.5 degrees F. The facility has a AC unit which controlled about 5 to 6 rooms in each unit. The thermostat are all set to 72 degrees, so if the temperature are lower than 72 degrees and the heater will be picked up. For summer time, when the temperature hits 76 degrees, the air conditioning would kick in. LPA observed all the thermostat in the facility and all are set to 72 degrees.

Allegation#4 "Resident was not provided medication in a timely manner. " LPA interviewed six (6) residents and four (4) residents denied the allegation and reported they do receive the medication on time and correct medication. They never experienced any medication problems in the facility. The executive director also stated all residents' medication needs to be written ordered or approved by the doctor before administer the medication to the residents.

Allegation#5 "Food not being prepared in a safe manner. " LPA interviewed six (6) residents and all residents reported all kitchen staff wears hairnet, gloves and masks while they prepared the food. They do not see any problems or issues with the kitchen staff. LPA interviewed staff and they denied the allegation. The executive director also reported all kitchen staff are required to wear hairnet, masks and gloves while they prepared the food.
NAME OF LICENSING PROGRAM MANAGER: Christine Yee
NAME OF LICENSING PROGRAM ANALYST: Christine Wong
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/27/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20211220120618
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: WHITTIER GLEN ASSISTED LIVING
FACILITY NUMBER: 198603162
VISIT DATE: 12/27/2021
NARRATIVE
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Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore all the allegations are UNSUBSTANTIATED.

Exit interview was conducted with administrator Sophia Chan and a copy of report and appeal right was provided.
NAME OF LICENSING PROGRAM MANAGER: Christine Yee
NAME OF LICENSING PROGRAM ANALYST: Christine Wong
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/27/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3