198603331-7-23-2021-28-AS-MVAO-C5HR9N-20210802124948

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603331
Report Date: 07/23/2021
Date Signed: 07/23/2021 11:05:38 AM

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
12/17/2020 and conducted by Evaluator Mary G Flores

COMPLAINT CONTROL NUMBER: 28-AS-20201217083850

FACILITY NAME:	BRIGHT STAR ASSISTED LIVING		FACILITY NUMBER:	198603331
ADMINISTRATOR:	MARQUEZ, JOSE M		FACILITY TYPE:	740
ADDRESS:	9349 ROSE STREET		TELEPHONE:	(818) 642-3668
CITY:	BELLFLOWER	STATE: CA	ZIP CODE:	90706
CAPACITY:	70	CENSUS: 19	DATE:	07/23/2021
		UNANNOUNCED	TIME BEGAN:	09:26 AM
MET WITH:	Maria Luisa Mascardo - Administrator		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility did not provide residents with sufficient notice prior to eviction

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst(s) (LPA) Mary Flores conducted an unannounced complaint investigation visit regarding the above allegation. LPA Flores met with Maria Luisa Mascardo, administrator and explained the reason for the visit.

On 12/22/21 LPA Flores conducted telephone interviews with the licensee, and LPA requested copies of staff and resident roster, any eviction notices for the month of December to be emailed to the LPA’s email by 12/24/20. On 7/23/21 LPA Flores interview administrator Maria Luisa Mascardo and requested staff/resident roster, a copy of physician's reports, needs and care plan, and physician's request for residents #1(R1), #2(R2), #3(R3), #4(R4), #5(R5), #6(R6).

The investigation revealed the following: Regarding allegation: Facility did not provide residents with sufficient notice prior to eviction. It is alleged facility owner evicted 19 residents without sufficient notice. Interview with administrator revealed there were no eviction letters provided to any residents during the month of December. There were 6 residents send to skill nursing facilities per doctor's request due to change in condition and need of higher level of care prior to December. (CONTINUED LIC (9099C).

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Rebecca Orendain
NAME OF LICENSING PROGRAM ANALYST: Mary G Flores
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2021

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-20201217083850

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: BRIGHT STAR ASSISTED LIVING	FACILITY NUMBER: 198603331
	VISIT DATE: 07/23/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

During interviews with residents 5 out 5 residents stated to have live at the facility for over a year and a half and to have never being asked to move out of the facility last year or at any time. During interviews with 4 out of 4 staff interviewed stated new management come in last year and remodeled the facility. 2 out of the 4 staff stated no residents were asked to leave or left the facility last year, and 2 out of the 4 staff stated that some residents were asked to move from the right side of the building due to remodeling, 1 out of the 2 staff stated that facility took care of the residents moving. Documents reviewed showed 6 residents were placed in a skilled nursing facility between September 21 to October 7, 2020 per physician's request due to a medical health condition that facility was not be able to provide care for.

Based on interviews, and documents reviewed conducted there preponderance of evidence standard has been met, therefore the above allegation(s) are found UNSUBSTANTIATED.

Exit interview was conducted with administrator Maria Luisa Mascardo and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: Rebecca Orendain
NAME OF LICENSING PROGRAM ANALYST: Mary G Flores
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 2