198603354-7-26-2024-28-AS-RORN-D8BL7D-20240820083006

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603354
Report Date: 07/26/2024
Date Signed: 07/26/2024 11:55:26 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
07/23/2024 and conducted by Evaluator Bonnie Tao

COMPLAINT CONTROL NUMBER: 28-AS-20240723121021

FACILITY NAME:	ASSISTED LIVING & WELLNESS		FACILITY NUMBER:	198603354
ADMINISTRATOR:	YU, DAVID		FACILITY TYPE:	740
ADDRESS:	608 WEST PALM DRIVE		TELEPHONE:	(626) 662-7101
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91007
CAPACITY:	6	CENSUS: 6	DATE:	07/26/2024
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Jennifer Sandoval, administrator assistant		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Staff are not maintaining a comfortable temperature for residents in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tao conducted an unannounced complaint investigation visit for the allegation listed above. During today’s visit, LPA met with Jennifer Sandoval, administrator assistant and spoke with administrator, Kenny Yu, over the phone. The purpose of today's visit was discussed.

Investigation consisted of the following: interview of staff#1 (S1), interviews of resident#1 (R1) and resident #2 (R2); reviewed facility record reviews, and conducted a physical plant. LPA obtained copies of the staff and resident rosters; and facility files with relevant information.

The investigation revealed the following:
In regard of staff are not maintaining a comfortable temperature for residents in care, it was alleged that facility’s air conditioner (AC) did not operate properly and the facility was hot.

(-continued in LIC 9099 C-)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Bonnie Tao	TELEPHONE: (323) 981-3971
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2024

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-20240723121021

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: ASSISTED LIVING & WELLNESS	FACILITY NUMBER: 198603354
	VISIT DATE: 07/26/2024

NARRATIVE

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All two (2) residents could not corroborate the allegation. Resident interviews revealed staff would turn on the AC and the room temperature was comfortable. All staff denied the allegation. Staff interview revealed staff took immediate action on the same day when staff was aware of the AC issue. Administrator hired AC technicians on 7/4/24 to check and fix the AC within 48 hours. During today’s investigation visit, the AC was on and working. The temperatures of residents’ rooms were in a range of 75 degree Fahrenheit to 76.4 degree Fahrenheit. The temperature of the living room was 78.3 degree Fahrenheit. Therefore, the facility provided a comfortable temperature for residents at the facility.

Based on the information obtained during the investigation, interviews with staff, residents, review of resident files and LPA's observation, the investigation did not reveal any evidence to support the allegations mentioned above.

Although the allegations may have happened or are valid, there is not preponderance of evidence to prove the alleged violations did or did not occur, therefore, the allegation is UNSUBSTANTIATED.

An exit interview was conducted with administrator assistant, Jennifer, and finding was discussed. A copy this report was provided at the time of visit.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Bonnie Tao	TELEPHONE: (323) 981-3971
LICENSING EVALUATOR SIGNATURE:	DATE: 07/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2024

LIC9099 (FAS) - (06/04)

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