198603416-4-21-2022-28-AS-MVAO-CEBSBN-20220511134415

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603416
Report Date: 04/21/2022
Date Signed: 04/21/2022 02:48:16 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
12/29/2021 and conducted by Evaluator Cynthia D Chan

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20211229085515

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: 114	DATE:	04/21/2022
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Kevin Taliafero, Executive Director		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff are not properly trained to provide care to residents.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cynthia Chan conducted a subsequent complaint investigation for the allegation listed above. LPA met with Executive Director, Kevin Taliaferro, and explained the purpose of the visit.

The investigation consisted of the following:
On 1/4/2022, LPA A. Lopez conducted the initial investigation and requested a copy of the staff and resident roster, and training logs. During the visit today, LPA Chan interviewed the Executive Director, 7 Staff, and 11 Residents. LPA obtained the course completion history for the care team from January 2021 to present.

The investigation revealed the following:
Regarding - Staff are not properly trained to provide care to residents. LPA interviewed the Administrator and 7 staff. Per the Administrator, all his staff are fully trained and have more than the required annual hours of training.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 04/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2022

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-20211229085515

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: 04/21/2022

NARRATIVE

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He stated Staff receive ongoing training and since the start of the Coronavirus (COVID-19) pandemic, staff has been provided with additional in-services to better assist residents. LPA obtained documentation of training hours for the care team and medtechs from 2021 to present. LPA reviewed the course completion history and observed that care and medication staff have at least 4 hours of training annually in one or more of the content areas as required in the Title 22 regulations. Staff interviewed indicated that they receive annual training such as Resident Rights, observing and reporting changes in residents’ behavior/conditions, and proper transferring of residents. They all stated they receive training monthly and feel that they are adequately trained to perform their duties. The facility utilizes the RELIAS program to monitor staff training. LPA interviewed 11 residents who believe the staff are properly trained. They are nice, respectful, and helpful. Staff assist some with their activities of daily living (ADLs) while others will occasionally press their pendants when they need assistance.

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.

An exit interview was conducted with staff. A copy of this report was provided.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Cynthia D Chan	TELEPHONE: (323) 981-3370
LICENSING EVALUATOR SIGNATURE:	DATE: 04/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2022

LIC9099 (FAS) - (06/04)

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