198603416-6-12-2023-28-AS-LHIS-CT7P7Q-20230627110419

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603416
Report Date: 06/12/2023
Date Signed: 06/12/2023 02:42:14 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
06/02/2023 and conducted by Evaluator Angelica Rea

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230602102954

FACILITY NAME:	MORNINGSTAR OF PASADENA		FACILITY NUMBER:	198603416
ADMINISTRATOR:	TALIAFERRO, KEVIN		FACILITY TYPE:	740
ADDRESS:	951 S. FAIR OAKS AVENUE		TELEPHONE:	(626) 204-1700
CITY:	PASADENA	STATE: CA	ZIP CODE:	91105
CAPACITY:	310	CENSUS: 143	DATE:	06/12/2023
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Kevin Taliaferro		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff finanically abused resident in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Angelica Rea conducted a visit in response to the above allegation. On today's visit, LPA met with Administrator, Kevin Taliaferro who assisted with today's visit.

Regarding the allegation that : Staff Financially abused resident in care. The investigation consisted of interview(s) with Administrator, Staff #1, resident #1, resident #1's Power of Attorney (POA), and review of resident #1's file. Administrator stated that he was aware of an incident regarding resident #1. Administrator stated that resident #1's nephew is his Power of Attorney (POA). Administrator stated that resident #1's POA called to speak to Administrator regarding some unusual activity on resident #1's account. Administrator stated that resident #1's POA came to the facility and took resident #1 to the Police Department. Administrator stated that the details of the investigation were not disclosed to the facility, as it was a private matter. Staff #1 was not aware of specific details of the allegation. Resident #1 stated that he thinks he lost his ATM card, or it was stolen. He said that a few hundred dollars was taken from his account. Resident #1 stated that the facility does not handle his finances.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica Rea	TELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:	DATE: 06/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023

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-20230602102954

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: MORNINGSTAR OF PASADENA	FACILITY NUMBER: 198603416
	VISIT DATE: 06/12/2023

NARRATIVE

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Resident #1 stated that he believes it may have been a private caregiver that was assisting him for a couple of months. However, he doesn't want to press charges since he doesn't have any proof. Resident #1's POA stated that the facility does not handle resident #1's finances, and stated that resident #1 had a temporary private caregiver when the ATM charges occurred. Resident #1's POA stated that he has informed the agency that the private caregiver worked for regarding this incident.

Based on LPA's observations and interviews, investigation revealed: 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: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Angelica Rea	TELEPHONE: (323) 980-4929
LICENSING EVALUATOR SIGNATURE:	DATE: 06/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/12/2023

LIC9099 (FAS) - (06/04)

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