198603222-11-27-2023-28-AS-LHIS-CY7KVV-20231204071459

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603222
Report Date: 11/27/2023
Date Signed: 11/27/2023 04:56:06 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
05/11/2023 and conducted by Evaluator Angelica Rea

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230511155149

FACILITY NAME:	WHITTIER PLACE SENIOR LIVING		FACILITY NUMBER:	198603222
ADMINISTRATOR:	WASHINGTON, MELANIE		FACILITY TYPE:	740
ADDRESS:	12315 BURGESS AVENUE		TELEPHONE:	(562) 777-1477
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90604
CAPACITY:	125	CENSUS: 64	DATE:	11/27/2023
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Joshua Castillo		TIME COMPLETED:	05:15 PM

ALLEGATION(S):

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Resident sustained unexplained injuries while in care and supervision of the facility
Staff failed to maintain facility clean and sanitary for resident in care
Facility has insufficient staffing to meet residents needs.
Facility did not conduct reappraisal for resident as needed

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angelica Rea conducted an unannounced visit to deliver the final results of the investigation. LPA met with Administrator, Joshua Castillo who assisted with today's visit.

Regarding the allegation that : Resident #1 sustained unexplained injuries while in care and supervision of the facility. The investigation consisted of review of resident #1's file, interviews with Administrator, and staff #1 - staff #4. The investigation revealed : Resident #1 lived at the facility from 2/25/23 to 3/22/23. Administrator and staff interviewed were not aware of any unexplained injuries sustained by resident #1.
Review of resident #1's flie, indicates that resident #1 was taking medication that can cause bruising.

Regarding the allegation that : Staff failed to maintain facility clean and sanitary for resident in care. The investigation consisted of tour of facility, including common areas, and resident rooms in assisted living and in memory care, and interviews with Administrator and staff #1 - staff #4.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica Rea	TELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:	DATE: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

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-20230511155149

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: 11/27/2023

NARRATIVE

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The investigation revealed : LPA toured facility on initial visit, and on subsequent visit. LPA observed that the facility was clean and sanitary on both visits. Administrator and Staff interviewed stated that the facility is cleaned daily, and resident rooms are cleaned once per week, and more often, if needed. They stated that the housekeeping department has a cleaning schedule to ensure that all resident rooms are cleaned.

Regarding the allegation that : Facility has insufficient staffing to meet residents needs. The investigation consisted of review of resident and staff roster(s), and interviews with Administrator and staff #1 - staff #4. The investigation revealed : Administrator and staff interviewed stated that the facility has sufficient staff to meet resident needs. Administrator and staff stated that both the assisted living and memory care have sufficient staff. LPA observed that the facility staff roster(s), and it appears that the facility has sufficient staffing to meet resident needs.

Regarding the allegation that : Facility did not conduct reappraisal for resident as needed. The investigation consisted of review of resident #1's file, and interview with Administrator. The investigation revealed : Resident #1 lived at the facility from 2/25/23 to 3/22/23. Review of resident #1's file indicated that resident #1's pre-placement appraisal was completed. Administrator stated that the facility conducts a reappraisal after 30 days of admission, and then 6 months thereafter, or as needed. However, resident #1 did not live at the facility long enough to have a reappraisal conducted.

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 was conducted with Mr. Castillo, and copy of report was provided.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica Rea	TELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:	DATE: 11/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/27/2023

LIC9099 (FAS) - (06/04)

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