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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603222
Report Date: 01/23/2024
Date Signed: 01/23/2024 03:10:10 PM

Substantiated


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
10/11/2023 and conducted by Evaluator Angelica Rea
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20231011155531
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: 67DATE:
01/23/2024
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Joshua CastilloTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Facility has scabies outbreak
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Angelica Rea conducted another 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: the facility has a scabies outbreak. The investigation consisted of interviews with Administrator, Hospice Nurse Director, and Los Angeles County Department of Public Health (LACDPH) Nurse. LPA also reviewed resident #1- resident #4 files, including Medication Administration Records.

Administrator stated that there were some residents in memory care that had complaints of itching. He stated that the residents were not diagnosed with scabies, however they were prescribed with medication to treat their skin condition(s). LPA reviewed 4 resident files, and observed that 4 memory care residents were being treated for a skin condition, consistent with scabies. Interview with Hospice Nurse Director indicated that sometimes they do not do skin scraping on hospice resident(s) to determine if a resident has scabies. LPA observed that resident #1 - resident #4's skin condition(s) were being treated as scabies and medication was prescribed.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica ReaTELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2024
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 3
Control Number 28-AS-20231011155531
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: 01/23/2024
NARRATIVE
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LPA spoke to LACDPH nurse who stated that they conducted an investigation into an outbreak of Rash/Scabies at the facility. LPA obtained information that there were a total of 10 cases reported, the first onset was in August 2023, and the last onset was in November 2023. LPA obtained a copy of the outbreak site clearance notification dated 12/19/23, which was provided to the facility. The facility failed to report the scabies outbreak to community care licensing as required.

Based on record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Deficiencies are being cited according to California Code of Regulations, Title 22 and Health and Safety Code.

An exit interview was conducted with Mr. Castillo.

A copy of the report and appeal rights were provided.
SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica ReaTELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3
Control Number 28-AS-20231011155531
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
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/24/2024
Section Cited
CCR
87211(a)(2)
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(a) Each licensee shall furnish to the licensing agency such reports as the Department may require, including, but not limited to, the following: (2) Occurrences, such as epidemic outbreaks, poisonings, catastrophes or major accidents which threaten the welfare, safety or health of residents, personnel or visitors, shall be reported within 24 hours either by telephone or facsimile to the licensing agency and to the local health officer when appropriate.
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Administrator will ensure that Title 22 regulations are being followed. Administrator will review Section 87211, and will send LPA a written statement indicating that the section has been read, and is understood.

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This requirement is not being met as evidenced by: Administrator did not submit a special incident report to Community Care Licensing indicating the facility had a scabies outbreak.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Lisa HicksTELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica ReaTELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3