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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603331
Report Date: 03/22/2022
Date Signed: 03/22/2022 02:49:58 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
11/24/2020 and conducted by Evaluator David Sicairos
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20201124122747
FACILITY NAME:BRIGHT STAR ASSISTED LIVINGFACILITY NUMBER:
198603331
ADMINISTRATOR:MARQUEZ, JOSE MFACILITY TYPE:
740
ADDRESS:9349 ROSE STREETTELEPHONE:
(818) 642-3668
CITY:BELLFLOWERSTATE: CAZIP CODE:
90706
CAPACITY:70CENSUS: 51DATE:
03/22/2022
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Maria Luisa Mascardo; AdministratorTIME COMPLETED:
03:04 PM
ALLEGATION(S):
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Unqualified staff are providing care and supervision to residents.
Licensee is not ensuring that building modifications meet local requirements.
Facility is in disrepair.
Facility staff did not report an outbreak as required.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) David Sicairos conducted an unannounced complaint visit regarding the above stated allegations. LPA met with Administrator Maria Luisa Mascarado and explained the reason for the visit.

The investigation consisted of the following: during the initial televisit conducted on 12/04/20, LPA interviewed the former Administrator Jose Marquez. LPA also obtained copies of staff and resident rosters. During today's visit, LPA toured the facility which included the common areas. LPA also interviewed the current Administrator, Staff #1 - Staff #3 and Resident #1 - Resident # 6.

The investigation revealed the following: in regards to the allegation "unqualified staff are providing care and supervision to residents", it is alleged that housekeeping staff is providing personal and hygiene care to the residents rather than properly trained staff. Interviews conducted with staff members denied this allegation. Staff members interviewed indicated that they received initial training when they began working at the facility and continue to receive ongoing annual training. (CONTINUED ON 9099C)
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Stefanie Coronel
NAME OF LICENSING PROGRAM ANALYST: David Sicairos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
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-20201124122747
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: 03/22/2022
NARRATIVE
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Housekeeping staff interviewed denied providing personal and hygiene care to residents. Interviews conducted with residents also denied this allegation. Residents interviewed indicated that they feel that there is sufficient trained staff available to meet their needs. LPA reviewed In Service Training Folder and observed ongoing training is provided to staff. Therefore there was insufficient evidence to corroborate with this allegation.

In regards to the allegations "licensee is not ensuring that building modifications meet local requirements" and "facility is in disrepair", it is alleged that facility owner met with someone to purchase falsified bonds on repairs needed to the building in order to pass inspection. No other details provided. Interviews conducted with staff members denied these allegations. Administrator indicated facility obtained city permits prior to repairs and renovations. LPA obtained a copy of Inspection Record Card from the City of Bellflower dated 01/12/21. Licensee indicated that on 10/02/20 an email was sent to Licensing to inform the Department of renovations. On 10/13/20, Licensing conducted an in person tour of the physical plant and observed the facility was currently under renovations; the roof on the West, North and North East sections were being replaced, and the second floor or section C & D were also being renovated. Residents interviewed today indicated facility is currently not in disrepair and are happy with the renovations made to the facility. Repairs and renovations were completed for the safety and well being of the residents. Some residents were relocated to other facilities while renovations were being completed. LPA toured the facility during today's visit and did not observe the facility to be in disrepair. Therefore there was insufficient evidence to corroborate with this allegation.

In regards to the allegation "facility staff did not report an outbreak as required", it is alleged that facility has provided incorrect information about COVID outbreaks. Interviews conducted with staff members denied this allegation. Administrator indicated there were no active covid cases at the facility when the complaint was filed. Residents interviewed indicated they are unaware if there was a covid outbreak at the facility back in November 2020. Staff members interviewed who worked when this complaint was initially filed indicated that there was not a covid outbreak back in November 2020. Staff members interviewed indicated they continue to wear PPE and follow CDC, Community Care Licensing, and Public Health Guidelines. LPA did not obtain any evidence indicating that the facility failed to report a covid outbreak. Therefore there was insufficient evidence to corroborate with this allegation.

Based on statements and interviews conducted with staff, residents, review of resident files and facility file records, there was not enough supportive evidence to concur with the reported allegations. 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 this report was provided.
NAME OF LICENSING PROGRAM MANAGER: Stefanie Coronel
NAME OF LICENSING PROGRAM ANALYST: David Sicairos
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2