198603162-9-14-2023-28-AS-RORN-CVTTCV-20230919143722

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603162
Report Date: 09/14/2023
Date Signed: 09/14/2023 04:21:51 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
03/25/2021 and conducted by Evaluator Bonnie Tao

COMPLAINT CONTROL NUMBER: 28-AS-20210325142606

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: 75	DATE:	09/14/2023
		UNANNOUNCED	TIME BEGAN:	08:44 AM
MET WITH:	Michael Forsgren, administrator		TIME COMPLETED:	04:45 PM

ALLEGATION(S):

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Facility staff do not treat residents with dignity and respect.
Facility staff yell at residents in care.
Facility staff speak inappropriately to residents in care.
Resident's toileting needs are not being met.
Staff failing to ensure residents eating needs are being met while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tao conducted a subsequent unannounced complaint investigation for the allegations listed above today. LPA met Administrator, Michael Forsgren and explained the purpose of today's visit.

On 05/05/21, LPA Tao conducted the initial investigation visit telephonically due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures. LPA obtained staff roster, resident roster, Resident #1’s (R1) files and related documents. LPA interviewed staff and residents telephonically.

On 09/14/23, LPA Tao conducted a subsequent visit today. During the visit, LPA obtained copies of staff/resident rosters and dietitian report/menus, interviewed residents/staff, reviewed resident #1 (R1) records, conducted a facility tour and delivered findings.

(-continued in LIC 9099 C-)

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Bonnie Tao
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

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-20210325142606

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: 09/14/2023

NARRATIVE

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Investigation consisted of the following: interviews of staff from Staff1 (S1) to Staff#8 (S8) and Staff#8; attempted to interview Staff#7 (S7); interviews of residents from Resident#1 (R1) through Resident#8 (R8); attempted to interview resident #9 (R9), resident#10 (R10) and resident#11 (R11); reviewed resident#1’s record reviews, and conducted a facility tour.

In regard of the allegation, “facility staff do not treat residents with dignity and respect.” The investigation revealed the following: LPA attempted but failed to interview residents from R9 to R11. LPA interviewed a total of eight (8) residents. Six (6) out of eight (8) residents interviewed could not corroborate the allegation. Two (2) out of eight (8) residents stated staff were not being nice to them. Per staff interview, all seven (7) staff interviewed denied the allegation. Both staff and resident interviews revealed that residents were being treated nicely. LPA toured the facility and observed staff treated residents with proper manner during the visit. Thus, there was not preponderance of evidence to show staff failed to treat residents with dignity and respect.

In regard of the allegation, “facility staff yell at residents in care.” The investigation revealed the following: Per resident interviews, six (6) out of eight (8) residents interviewed could not corroborate the allegation. One (1) out of eight (8) residents stated staff talked loudly to resident which made resident felt staff was yelling. One (1) out of eight (8) residents stated staff yelled at resident. Per staff interview, all seven (7) staff interviewed denied the allegation. Per file review, no incident report during March 2021 was reported regarding staff yell at resident. During the visit, LPA did not hear staff yell at resident. Therefore, there was not preponderance of evidence to show facility staff yell at residents.

In regard of the allegation, “facility staff speak inappropriately to residents in care.” Per resident interviews, seven (7) out of eight (8) residents interviewed could not corroborate the allegation. One (1) out of eight (8) residents stated staff talked mean to resident. Per staff interviews, all seven (7) staff interviewed denied the allegation. Per file review, staff had in-service training on residents’ rights. Therefore, there was not preponderance of evidence to show facility staff speak inappropriately to residents in care.

In regard of the allegation, “resident's toileting needs are not being met,” it was alleged that resident’s toileting needs are not being met and some residents have to "sit in their soil" for a very long time. Per resident interviews, seven (7) out of eight (8) residents interviewed could not corroborate the allegation.
(-continued in LIC 9099 C-)

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Bonnie Tao
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20210325142606

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: 09/14/2023

NARRATIVE

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One (1) out of eight (8) residents stated staff did not assist resident as resident preferred. Per staff interviews, all seven (7) staff interviewed denied the allegation. LPA toured the facility and did not smell foul odor during the visit. Therefore, facility staff did not fail to meet resident's toileting needs.

In regard of the allegation, “staff failing to ensure residents eating needs are being met while in care,” it was alleged staff did not attend to help residents who needs assistance with feeding which caused residents did not eat enough food. LPA interviewed a total of eight (8) residents, including who need assistance with feeding. All eight (8) out of eight (8) residents interviewed could not corroborate the allegation. All seven (7) staff interviewed denied the allegation. Staff/residents interviews revealed residents’ eating needs are being met. Per file review, registered dietitian’s reports showed facility menus were reviewed and checked regularly. Alternate menu was available. LPA toured the facility and observed the facility had sufficient food supplies during the visit. Therefore, residents’ eating needs were met.

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

No deficiencies are being cited according to California Code of Regulations, Title 22, Division 6, Chapter 8.

An exit interview was conducted with Administrator. A hard copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Bonnie Tao
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2023

LIC9099 (FAS) - (06/04)

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