198603162-1-7-2021-28-AS-FFIS-C442JC-20210617172606

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603162
Report Date: 01/06/2021
Date Signed: 01/07/2021 09:53:48 AM

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
12/28/2020 and conducted by Evaluator Jose Villalobos

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20201228141443

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: 52	DATE:	01/06/2021
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Administrator Mona Tirado		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Staff smoke marijuana inside of the facility.
Resident(s) are not able to communicate with family members.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jose Villalobos initiated a complaint investigation for the allegation listed above. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, today’s complaint investigation was conducted telephonically with Administrator Mona Tirado.

The investigation consisted of the following: LPA conducted a virtual tour of the facility with administrator Mona. LPA conducted phone interviews with the Staff #1 - Staff #7 (S1-S7), Resident #1- Resident #6 (R1-R6). Resident #7 refused to interview. LPA also received a copy of the resident and staff roster via email.

In regards to the allegation "Staff smoke marijuana inside of the facility."The investigation revealed the following: It is alleged that med-tech staff smoke marijuana in the facility using vape pens while on shift. (7) of (7) staff interviewed denied the allegation. (6) of (6) Residents interviewed could not corroborate the allegation.

Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981- 3981
LICENSING EVALUATOR NAME: Jose Villalobos	TELEPHONE: (323) 980-4939
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2021

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-20201228141443

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: 01/06/2021

NARRATIVE

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During the tour, LPA did not observe any items that would corroborate the allegation. Based on observations interviews conducted with facility staff and clients, there was not enough supportive evidence to corroborate with the reported allegation.

In regards to the allegation "Resident(s) are not able to communicate with family members.",the investigation revealed the following: It is alleged that when family members call the facility to speak to residents, residents are not given the phone to speak with their families. During todays tour, LPA was able to observe 2 working cord phones on the first floor and 1 on the second floor available for resident use. Interviews with (7) of (7) staff state that residents are able to use the facility phones to take and make phone calls. The facility also has a cordless phone that is available to residents as well. (7) of (7) Staff stated that they also help residents will who need help getting to the phones when they have phone calls. (7) of (7) Staff deny the allegation that residents are not able to communicate with family members. Interviews with (6) of (6) Residents also shows that they are able to use the facility phone to make calls. Based on observations interviews conducted with facility staff and clients, there was not enough supportive evidence to corroborate with the reported allegation.
Although the allegation(s) 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(s) are UNSUBSTANTIATED.

Exit interview was conducted with administrator Mona Tirado and a hard copy was provided via email for signature.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981- 3981
LICENSING EVALUATOR NAME: Jose Villalobos	TELEPHONE: (323) 980-4939
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2021

LIC9099 (FAS) - (06/04)

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