198603162-9-13-2022-28-AS-RORN-CLNR58-20221130114240

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603162
Report Date: 09/13/2022
Date Signed: 09/13/2022 05:42:53 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
03/18/2022 and conducted by Evaluator Valeria Maldonado

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20220318101435

FACILITY NAME:	WHITTIER GLEN ASSISTED LIVING		FACILITY NUMBER:	198603162
ADMINISTRATOR:	ATEAIAN, KIMIA		FACILITY TYPE:	740
ADDRESS:	10615 JORDAN RD		TELEPHONE:	(562) 943-3724
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90603
CAPACITY:	93	CENSUS: 55	DATE:	09/13/2022
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Pamela Junge- Executive Director		TIME COMPLETED:	05:45 PM

ALLEGATION(S):

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Facility mismanged resident's medications.
Staff did not administer medications per doctor's orders.
Staff did not treat the resident with dignity.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) V. Maldonado made an unannoucend subsequent complaint visit to at the facility regarding the above mentioned allegations. LPA Maldonado met with Executive Director Pamela Junge and explained the purpose for the visit.

On 03/23/22, LPA Kruz Long made an initial complaint visit. During the visit, LPA Long obtained and reviewed a copy of the Staff schedule, Resident roster and Resident #1's records (Hospital discharge documents, Preplacement Appraisal Information, Physicians Report) and interviewed Staff #1 in the conference room at 11:15 am.

During today's visit, LPA Maldonado requested a copy of the staff and resident roster, and the following documents for Resident# 1 (R1). LPA also interviewed Staff# 1-4 (S1-S4) and Residents# 2-7 (R2-R7). LPA was unable to interview R1 due to resident no longer residing at the facility.
(Report Continued on LIC9099-C...)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Valeria Maldonado	TELEPHONE: 323-981-3342
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022

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-20220318101435

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: 09/13/2022

NARRATIVE

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Regarding allegation: Facility mismanged resident's medications.
Executive Director Pamela was unable to provide R1's MAR as resident was able to administer and store own medications. During review of R1's physician's report, it was confirmed that R1 was in fact able to store and administer own medications. It was also discovered that R1 was prescribed a PRN (as needed) medication for 7 days. The medication was ordered and started on 2/26/22 at 8:34 a.m. and was to be taken until 3/5/22. During interviews conducted with R2-R7, (3) of (6) residents stated staff assist them with administering their medications and have never had an incident where they mismanaged the residents' medications. (6) of (6) residents stated they have no knowledge of residents stating that the facility mismanaged the residents medications. During interviews conducted with S1-S4, (4) of (4) staff stated they have no knowledge of an incident where the facility mismanaged resident medications. If they had knowledge, they would report it right away to Licensing, their physician, and the families.
Regarding allegation: Staff did not administer medications per doctor's orders.
During interviews conducted with S1-S4, staff always administer medications per doctor's orders. During interviews with R2-R7, (3) of (6) residents who are assisted by staff with administering their medication, stated that they have no concerns with staff not administering their medications per doctor's orders. (6) of (6) residents have no knowledge of an incident where a resident expressed that staff did not administer their medication per doctor's orders.
Regarding allegation: Staff did not treat the resident with dignity.
During interviews conducted with R2-R7, (6) of (6) residents state they have never felt like staff did not treat them with dignity. All residents interviewed stated that staff at the facility are great. (1) of (6) residents stated there is 1 resident they witnessed to be teased behind their back about their weight and "feels bad" about that occurring. Otherwise, staff are great to everyone else. During interviews conducted with S1-S4, no one has witnessed or has knowledge of other staff not treating residents with dignity. Al staff interviewed stated if they had knowledge, they would report it.

Based on the interviews conducted, observations and files reviewed, there was not enough supportive evidence to concur with the reported 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 UNSUBSTANTIATED.

An exit interview was conducted with Executive Director Pamela Junge and a copy of this report was provided.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Valeria Maldonado	TELEPHONE: 323-981-3342
LICENSING EVALUATOR SIGNATURE:	DATE: 09/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/13/2022

LIC9099 (FAS) - (06/04)

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