198603286-1-4-2024-28-AS-FFIS-CZASD9-20240108124644

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603286
Report Date: 01/04/2024
Date Signed: 01/04/2024 04:31:10 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
07/03/2023 and conducted by Evaluator Ashley Calderon

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230703095829

FACILITY NAME:	PASADENA VILLA SENIOR LIVING		FACILITY NUMBER:	198603286
ADMINISTRATOR:	MURPHY, MICHAEL		FACILITY TYPE:	740
ADDRESS:	1811 N. RAYMOND AVE		TELEPHONE:	(626) 791-6232
CITY:	PASADENA	STATE: CA	ZIP CODE:	91103
CAPACITY:	97	CENSUS: 74	DATE:	01/04/2024
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Assistant Administrator-Alexander Solorio		TIME COMPLETED:	01:35 PM

ALLEGATION(S):

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Staff are unable to communicate with resident due to a language barrier.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ashley Calderon conducted an unannounced subsequent complaint visit to investigate the aboved allegation. LPA met with Alexander Solorio (Assistant Administrator) and explained the reason for the visit.

On 07/06/2023,the investigation consisted of the following: LPA Calderon collected staff and resident roster. LPA interviewed Residents #1-#7. (R1-R7) and interviewed Assistant Administrator Alexander Solorio and Staff #1 (S1).

On today's visit 1/4/23, LPA's investigation consisted of interview with Staff #2-Staff #4 (S1-S4).

Based on allegation: Staff are unable to communicate with resident due to a language barrier.

Continuation on 9099-C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Ashley Calderon	TELEPHONE: (323) 981-3984
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2024

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-20230703095829

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: PASADENA VILLA SENIOR LIVING	FACILITY NUMBER: 198603286
	VISIT DATE: 01/04/2024

NARRATIVE

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Interviews LPA conducted with Assistant Administrator, S1-S4 informed LPA that although some staff aren't fluent in English, staff understand requests from residents and based on staff and resident's preferred / native language spoken in and in order to communicate among each other staff use google translator when needed to communicate with residents. Assistant Administrator informed LPA having staff that speak English present during each shift and providing resident's and ensuring residents are able to communicate their needs.. (7) out of (7) residents interviewed on visit date 7/6/23 informed LPA not being able to collaborate if other residents who reside at the facility are unable to communicate with staff do to language barriers. (6) out of (7) residents informed LPA that as for their communication needs with staff, staff can communicate with them and language barrier does not interfere with communication. LPA observed during time of visit English and Spanish speaking staff and residents. LPA observed interactions with staff and residents and residents and staff are able to communicate with each other.

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 held and a copy of the report was provided

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Ashley Calderon	TELEPHONE: (323) 981-3984
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2024

LIC9099 (FAS) - (06/04)

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