198603162-8-5-2024-28-AS-RORN-D8CPLP-20240821112503

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603162
Report Date: 08/05/2024
Date Signed: 08/05/2024 04:12:26 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
08/01/2024 and conducted by Evaluator Nune Margaryan

COMPLAINT CONTROL NUMBER: 28-AS-20240801160346

FACILITY NAME:	WHITTIER GLEN ASSISTED LIVING		FACILITY NUMBER:	198603162
ADMINISTRATOR:	BARBA AGUIRRE, ITZAYANA		FACILITY TYPE:	740
ADDRESS:	10615 JORDAN RD		TELEPHONE:	(562) 943-3724
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90603
CAPACITY:	93	CENSUS: 79	DATE:	08/05/2024
		UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Citlali Galeana Welness Coordinator		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Facility staff not ensuring kitchen is free of cockroaches.
Facility staff not following proper infection control practices.
Facility staff served resident food from the floor.
Facility staff not maintaining kitchen equipment in a clean condition.
Facility staff not serving meals with adequate portion sizes.
Facility staff not ensuring kitchen is clean.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Nune Margaryan conducted an unannounced initial complaint investigation for the allegations listed above. LPA met with Welness Coordinator Citlali Galeana and explained the purpose of vist.

On today's visit LPA toured the facility including kitchen and dinning room. LPA interviewed Welness Coordinator, Staff 1- Staff 3 (S1-S3) and Residents 1- Resident 8 (R1-R8) and collected the following documents: Staff and Resident Roster, copy of the food menu for the weeks of 07/21/24 - 07/27/24, 07/28/24 - 08/03/24,08/04/24 - 08/10/24, 08/11/24 - 08/17/24, reviewed documentation of pest control services for the months of June and July and Juice machine service work orders for the month of August 2024.

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Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3378
LICENSING EVALUATOR NAME: Nune Margaryan	TELEPHONE: 323-981-3378
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2024

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 28-AS-20240801160346

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: 08/05/2024

NARRATIVE

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In regards to the allegations "Facility staff not ensuring kitchen is clean and facility staff not ensuring dining room / kitchen is free of cockroaches". It was alleged that kitchen is not clean and there are cockroaches. LPA toured the kitchen and dining room and observed lunch being served. The kitchen and dining room were clean. LPA didn't observe any evidence of cockroaches in the kitchen or in the dining room. Interviewed Wellness Coordinator (WC) and staff denied the allegations. Interviews with staff show that the kitchen and dining room are cleaned before and after each mealtime. During the investigation LPA observed staff are cleaning tables and mopping dining area after lunch. Interviewed WC stated that pest control comes every month as a preventative measure. LPA reviewed facility pest control invoices (service dates: 06/10/24, 07/08/24, 07/22/24) and no cockroach activity was noted during the inspections and / or services. Residents interviewed could not corroborate the allegations. Interviewed residents stated that they have not seen any cockroaches in the kitchen / dining area.

In regards to the allegation "Facility staff not following proper infection control practices". It was alleged that kitchen staff is coughing and not covering his/her mouth and not wearing gloves. Interviewed staff denied the allegations. WC stated that not witnessed any kitchen staff coughing without covering their mouth. If the staff member is sick, they are advised to call out sick or wear a mask. All kitchen staff are aware that they need to wear gloves when handling food. All interviewed staff stated that they are not coughing without covering their mouth. They were not witnessed that kitchen staff coughing and not covering their mouth. They stated they always wearing gloves in the kitchen. LPA observed kitchen staff serving lunch at the time of visit. Kitchen staff were observed to be wearing gloves while working in the kitchen and serving the meals to the residents.

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SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3378
LICENSING EVALUATOR NAME: Nune Margaryan	TELEPHONE: 323-981-3378
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2024

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20240801160346

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: 08/05/2024

NARRATIVE

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In regards to the allegations "Facility staff not serving meals with adequate portion size and facility staff served resident food from the floor". It was alleged that residents are complaining that portions are small and kitchen staff served resident food from the floor". LPA observed the dining area during lunch time. LPA observed the meal that was served to the residents. They were served carnitas with beans and rice and vegetable. As a desert they had vanilla pudding. LPA noted that residents were served with variety of juices, milk, and coffee. The portions of the meals were appropriate. LPA reviewed the approved menu that facility was currently using. Facility had five week cycle. Interviews with Staff indicated that the facility does provide residents with adequate meals, of good quality and sufficient portions. Interviews with Residents 1- 8 indicated that the facility serves adequate meals, and the portion size is also adequate. Interviewed staff stated that kitchen staff will never serve residents food from the floor. S1 and S2 stated that they cook quite a lot of food and If food falls on the floor, they throw it away. Residents interviewed could not corroborate the allegations. Interviewed residents stated that they never witnessed that staff serve food from the floor.

In regards to the allegation "Facility staff not maintaining kitchen equipment in a clean condition". It was alleged that the juice machines tubes are moldy, they haven’t been changed.

LPA tour the kitchen and did not observe juice machines tubes are moldy. Interviewed kitchen staff denied the allegation that juice machine tubes or any kitchen equipment are moldy. S1 stated that staff clean / sanitize juice machine tubs constantly with hot water, when changing the juice BiBs ( Bag-in-Box). Also Juice machine is maintenance from "Quick Dispense" company and last service done in August 2024. Interviewed WC didn't hear complain from staff that any kitchen equipment are moldy.

Although the allegation(s) may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are Unsubstantiated.

Exit interview was conducted with Wellness Coordinator. A copy of the report was issued.

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3378
LICENSING EVALUATOR NAME: Nune Margaryan	TELEPHONE: 323-981-3378
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2024

LIC9099 (FAS) - (06/04)

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