198603183-9-2-2020-28-AS-AJKK-BUKUR8-20201020154819

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603183
Report Date: 09/01/2020
Date Signed: 09/02/2020 07:40:43 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
08/24/2020 and conducted by Evaluator David Sicairos

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20200824090436

FACILITY NAME:	COUNTRY VIEW ASSISTED LIVING		FACILITY NUMBER:	198603183
ADMINISTRATOR:	ALBA, HELEN		FACILITY TYPE:	740
ADDRESS:	824 W. CAMERON AVE		TELEPHONE:	(626) 962-3511
CITY:	W. COVINA	STATE: CA	ZIP CODE:	91790
CAPACITY:	136	CENSUS: 110	DATE:	09/01/2020
		UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Dennise Torres & Samuel Deutsch		TIME COMPLETED:	11:55 AM

ALLEGATION(S):

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Staff yell at residents in care.
Staff not meeting residents medical needs.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) David Sicairos initiated a complaint investigation for the allegations 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 Assistant Administrator Dennise Torres.

The investigation consisted of the following: During initial televisit conducted on 08/28/20, LPA interviewed the Administrator, Staff #1, and Staff #2. LPA also requested copies of resident & staff rosters. During today's televisit, LPA interviewed Staff #3, and Resident #1 - Resident #11 between 10:45am - 11:55am.

The investigation revealed the following: in regards to the allegation "staff yell at residents in care", it is alleged that staff members yell at all the residents. Staff are allegedly very rude to residents, however specific examples of what staff say were not provided.
(CONTINUED ON 9099C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Rebecca Orendain	TELEPHONE: (323) 981-3961
LICENSING EVALUATOR NAME: David Sicairos	TELEPHONE: (323) 981-3961
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2020

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-20200824090436

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: COUNTRY VIEW ASSISTED LIVING	FACILITY NUMBER: 198603183
	VISIT DATE: 09/01/2020

NARRATIVE

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Interviews conducted with facility staff members all denied yelling at residents and all denied being rude to residents. Staff members indicated that they treat all residents with dignity and respect. All staff members interviewed indicated that they receive Personal Rights training upon hire. All of the residents who were interviewed denied that staff are rude to them or that staff yells at them. Therefore there was insufficient evidence to corroborate with this allegation.

In regards to the allegation "staff not meeting resident medical needs", it is alleged that the staff are not meeting residents medical needs or taking them to their appointments. Administrator indicated that the due to the situation surrounding COVID-19, the facility is trying to limit how often people come and go from the facility due to the high risk population that is being served. However, Administrator indicated that residents are not prohibited from leaving the facility to attend appointments. Administrator indicated some doctors visits are done via Zoom, FaceTime, Google Duo, etc from the facility. There is also an in-house doctor that comes to the facility once a week. Specialized doctors such as Dermatologists, Podriatists, Optometrists, etc. come to the facility on a "as needed basis". All residents interviewed indicated that they have had recent contact with their doctors and that they are allowed to leave the facility to attend doctors appointments if needed. Residents interviewed also indicated that there are in-house doctors that come to the facility for any medical needs that they may have. Therefore there was insufficient evidence to corroborate with the allegation.

Based on statements and interviews conducted with staff, clients, review of client files and facility file records, there was not enough supportive evidence to concur with the reported allegations. Although the allegations 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.

Telephonic exit interview held, and a copy of this report was emailed to Administrator & Assistant Administrator for signature.

SUPERVISOR'S NAME: Rebecca Orendain	TELEPHONE: (323) 981-3961
LICENSING EVALUATOR NAME: David Sicairos	TELEPHONE: (323) 981-3961
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2020

LIC9099 (FAS) - (06/04)

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