198603504-2-23-2024-28-AS-LHIS-D2TKRZ-20240226070842

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603504
Report Date: 02/23/2024
Date Signed: 02/23/2024 02:55:37 PM

Substantiated

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
02/10/2022 and conducted by Evaluator Noemi Galarza

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20220210145845

FACILITY NAME:	LA POSADA		FACILITY NUMBER:	198603504
ADMINISTRATOR:	HILL, JANETTE		FACILITY TYPE:	740
ADDRESS:	8120 PAINTER AVE		TELEPHONE:	(562) 945-2651
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90602
CAPACITY:	114	CENSUS: 90	DATE:	02/23/2024
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Diana Bautista, Administrator		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Facility is understaffed.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Galarza conducted a subsequent complaint visit to deliver findings on the above allegation. The purpose of the visit was discussed telephonically Administrator Diana Bautista.

The investigation consisted of: On 2/15/2022, LPA toured all areas of the facility. Staff (S1-S7), residents (R1- R7), and Family (F1) were interviewed. Copies of Shower Lists [Hospice Shower Names, AM Shower list, PM Shower list], List of residents on 2-hour checks [17 residents], Assisted Living Dining Room Census, Staff Shift Schedule Dates- 1/3/2022- 2/13/2022 , LIC 500 Personnel Report and Resident Roster were obtained. During today's visit, no health and safety issues were observed.

***Narrative continues next page.***

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi Galarza	TELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024

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 3

Control Number 28-AS-20220210145845

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: LA POSADA	FACILITY NUMBER: 198603504
	VISIT DATE: 02/23/2024

NARRATIVE

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Allegation: Facility is understaffed. It is alleged that due to staffing shortages staff are working 12 hour shifts and are still not meeting the bathing, incontinence care, and feeding needs of residents in a timely manner. According to information obtained, the facility hired registry staff to fill major staffing shortages, but the staffing numbers have insufficient to meet the needs of residents, especially during early January 2022 COVID -19 outbreak. A total of 7 residents interviewed, of which five (5) stated the facility was very short staffed and were not responding to their needs in a timely manner. All seven (7) staff confirmed the allegation. Administrator stated that the facility had staffing shortages since August 2021- through February 2022, which resulted in assigning all staff 12-hour shifts, and assigning med-tech staff caregiver duties in the Assisted Living floors. Registry staff were discontinued on Feb. 14, 2022, and the facility planned to keep the 12-hour shifts until all regular staff vacancies were filled. Staff reported that although registry staff were hired, sometimes they did not show up, and/or new staff were hired and they quit right away due to long hours and work load responsibilities. In addition, at least one staff was working 12-hours a day, 6 days a week in order because of staff shortages. Based on record review, the allegation was supported.

Based on record review and interviews conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Deficiency is being cited.

Exit interview was conducted and a copy of the report and appeal rights were issued.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi Galarza	TELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 28-AS-20220210145845

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: LA POSADA	FACILITY NUMBER: 198603504
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/23/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/01/2024 Section Cited CCR 87411(a)	1 2 3 4 5 6 7	Personnel Requirements - General. Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs. This requirement was not met by evidence of:	1 2 3 4 5 6 7	Administrator agreed to submit a plan that ensures sufficient staffing is in place at all times, and staff receive continuous training in personnel responsibilities.
	8 9 10 11 12 13 14	Based on interviews conducted and record review, between Aug. 2021- Feb. 2022, there were staff shortages, and so the facility hired registry staff, but still could not meet the needs of residents. This posed a potential health and safety risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi Galarza	TELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2024

LIC9099 (FAS) - (06/04)

Page: 3 of 3