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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603222
Report Date: 05/06/2024
Date Signed: 05/06/2024 03:09:36 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
03/21/2023 and conducted by Evaluator Angelica Rea
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20230321160829
FACILITY NAME:WHITTIER PLACE SENIOR LIVINGFACILITY NUMBER:
198603222
ADMINISTRATOR:WASHINGTON, MELANIEFACILITY TYPE:
740
ADDRESS:12315 BURGESS AVENUETELEPHONE:
(562) 777-1477
CITY:WHITTIERSTATE: CAZIP CODE:
90604
CAPACITY:125CENSUS: 61DATE:
05/06/2024
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Joshua Castillo TIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Uncleared staff caring for residents in care.
Staff do not meet required qualifications.
Staff do not address pest infestation.
Staff do not address rodent infestation.
Staff do not ensure facility is free of disturbances.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Angelica Rea conducted another visit in response to the above allegations. LPA met with Administrator, Joshua Castillo who assisted with the visit.

Regarding the allegation that there are : Uncleared staff caring for residents in care. The investigation consisted of interviews with Administrator, staff #1 - staff #7, resident #1 - resident #6, and review of staff files, facility staff roster and facility staff clearance documents. Administrator and staff interviewed were unable to corroborate the allegation. Eight out of eight staff interviewed stated that there are no uncleared staff caring for residents in care. Residents interviewed were unable to corroborate the allegation. SIx out of six residents interviewed stated that they do not know if there are uncleared staff caring for residents in care. LPA review of staff clearance documents, indicate that there are no uncleared staff caring for residents in care.

Regarding the allegation that : Staff do not meet required qualifications, specifically that the medication technicians are not certified, and the kitchen staff are not certified.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica ReaTELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 28-AS-20230321160829
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 PLACE SENIOR LIVING
FACILITY NUMBER: 198603222
VISIT DATE: 05/06/2024
NARRATIVE
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The investigation consisted of interviews with Administrator, staff #1 - staff #7, resident #1 - resident #6, and review of staff files, including medication certification(s), and kitchen staff certification(s). Administrator, and staff interviewed were unable to corroborate the allegation. Eight out of eight staff interviewed stated that the medication and kitchen staff are certified and meet the required qualifications. Residents interviewed were unable to corroborate the allegation. SIx out of six residents interviewed stated that the facility staff meet the required qualifications to their knowledge. LPA reviewed staff files, and observed that the medication technicians and kitchen staff meet the required qualifications.

Regarding the allegation(s) that : Staff do not address pest infestation, and staff do not address rodent infestation. The investigation consisted of interviews with Administrator, staff #1 - staff #7, resident #1 - resident #6, tour of facility, and review of recent pest control invoices. Administrator and staff interviewed denied the allegation. Administrator stated that the facility has a contract with a pest control company as a preventative measure. Eight out of eight staff interviewed stated that they have not observed any pests or rodents at the facility. Residents interviewed were unable to corroborate the allegation. Six out of six residents interviewed stated that they have not observed any pests or rodents at the facility. LPA did not observe any pests or rodents during the facility tour. Facility pest control receipts do not indicate that the facility has an infestation of pests or rodents at this time.

Regarding the allegation that : Staff do not ensure facility is free of disturbances. The investigation consisted of interviews with Administrator, staff #1 - staff #7, resident #1 - resident #6, and tour of facility. Administrator and staff interviewed were unable to corroborate the allegation. Eight out of eight staff interviewed stated that the staff do ensure that the facility is free of disturbances. Residents interviewed were unable to corroborate the allegation. Six out of six residents interviewed stated that staff do ensure that the facility is free of disturbances.

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.

Exit interview conducted, and a copy of the report was provided to Mr. Castillo.
SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica ReaTELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:

DATE: 05/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/06/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2