198603384-7-2-2024-28-AS-WSHO-D6ZTPB-20240709145402

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603384
Report Date: 07/02/2024
Date Signed: 07/02/2024 12:10:07 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
06/27/2024 and conducted by Evaluator Glenn Trueman

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240627153804

FACILITY NAME:	PASADENA HIGHLANDS		FACILITY NUMBER:	198603384
ADMINISTRATOR:	KAY CANO		FACILITY TYPE:	740
ADDRESS:	1575 E WASHINGTON BLVD		TELEPHONE:	(801) 815-0808
CITY:	PASADENA	STATE: CA	ZIP CODE:	91104
CAPACITY:	245	CENSUS: 190	DATE:	07/02/2024
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Kay Cano		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Staff do not keep the facility free from pest.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Glenn Trueman conducted an unannounced complaint investigation visit for the allegation listed above. LPA Trueman met with Administrator Kay Cano and the purpose of the visit was discussed.

At today's visit 07/02/24, LPA has completed the following: LPA collected a copy of the staff and resident roster, LPA Interviewed Staff #1- #3 (S1-S3) and Residents #1-#8 (R1-R8). LPA toured the physical plant including the outside gardens and along the walls. LPA inspected the facilities food supply, kitchen area and dining room, LPA reviewed documentation of pest control services contracted by the facility for the last 2 months. The investigation revealed the following:
In regards to the allegation Staff do not keep the facility free from pest, based on interviews conducted and information gathered it was revealed that 8 out of 8 residents stated that the food service is good and that they had never observed roaches, rodents or flies and had not been told by anyone about roaches, rodents or flies in the dining room and kitchen area.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Glenn Trueman	TELEPHONE: (323) 981-1652
LICENSING EVALUATOR SIGNATURE:	DATE: 07/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024

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-20240627153804

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 HIGHLANDS	FACILITY NUMBER: 198603384
	VISIT DATE: 07/02/2024

NARRATIVE

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Staff #1- # 3 all stated they have not observed any roaches or rodents in the kitchen and dining room area,
Stated that pest control comes every Monday and traps are also set up as a preventative measure.
Administrator stated that routine exterminators come to the facility. Stated they come 1x per week and they have not observed any roaches, rodents or flies.
LPA reviewed documentation and observed that there were visits conducted in May and June 2024 of general pest control maintenance to treat rodents, roaches and flies by Western Exterminator.
LPA inspected the facilities food supply, kitchen area and dining room and did not observe any rodents, roaches and flies.
It should also be noted that there was a previous complaint 28-AS-20240425201839 dated 04/25/24 that included the same allegation and findings were Unsubstantiated.

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

SUPERVISOR'S NAME: Wei Siew Ho	TELEPHONE: (323) 981-3969
LICENSING EVALUATOR NAME: Glenn Trueman	TELEPHONE: (323) 981-1652
LICENSING EVALUATOR SIGNATURE:	DATE: 07/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/02/2024

LIC9099 (FAS) - (06/04)

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