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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603504
Report Date: 03/14/2025
Date Signed: 09/11/2025 02:37:52 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
08/29/2024 and conducted by Evaluator Noemi Galarza
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240829114254
FACILITY NAME:LA POSADAFACILITY NUMBER:
198603504
ADMINISTRATOR:DIANA BAUTISTAFACILITY TYPE:
740
ADDRESS:8120 PAINTER AVETELEPHONE:
(562) 945-2651
CITY:WHITTIERSTATE: CAZIP CODE:
90602
CAPACITY:114CENSUS: 70DATE:
03/14/2025
UNANNOUNCEDTIME BEGAN:
09:13 AM
MET WITH:Beatriz Lui, Executive DirectorTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Staff handled resident in a rough manner resulting in an injury.
Staff did not prevent a resident from falling out of a window.
INVESTIGATION FINDINGS:
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***This amended report 9/11/2025 supersedes the report dated 3/14/2024 in reference to citation 87411(a). The citation is dismissed. On 3/14/2025 & 3/11/2025, Licensing Program Analyst (LPA) Galarza conducted a subsequent complaint visits to deliver findings on the above allegations. The purpose of the visit was discussed telephonically with Executive Director Beatriz Lui. Alyssa Morales met with LPA.

The investigation consisted of: On 9/6/24, LPA reviewed medications/medication administration records, and conducted a physical plant tour that included inspection of 17 resident rooms, kitchen, common areas, and Memory Care Unit. During subsequent visits Memory Care Unit, common areas, and random resident residents were inspected. A total of 7 staff (S1-S7) and 8 residents (R4- R11) were interviewed. Residenst (R1 & R3) moved out and were not interviewed and R2 is cognitively impaired. Former staff (S8 - S11) were not interviewed. Resident files were reviewed and relevant documents were obtained[Medication Administration Records (MARs) & pest control service invoices]. While the incident and resulting injuries are not disputed to have occurred, there is insufficient evidence to prove the resident required additional supervision. Exit interview was conducted with Business Office Manager Alyssa Morales. A copy of the report was provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2025
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 2
Control Number 28-AS-20240829114254
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: 03/14/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
03/15/2025
Section Cited
CCR
87411(a)
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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:
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Executive Director shall submit a plan of correction that includes in-service training regarding elopement, wandering behavior, methods of redirection, resident care and supervision procedures, and staff/resident ratio in Memory Care unit.
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On 7/1/2024, at approximately 6:30 PM Memory Care Unit resident (R1) climbed out of a 1st floor bedroom window, fell, and sustained head injuries and dislocated shoulder. Staff responsible for supervision of residents in activity room was assisting another resident in the bathroom. This posed an immediate health, saferty, and personal rights risk to persons in care.
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Deficiency Dismissed
Type B
03/18/2025
Section Cited
CCR
87468.2(a)(8)
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Personal Rights of Residents in All Facilities. In addition to the rights listed in Section 87468.1, Personal Rights of Residents in All Facilities, residents ..... shall have all of the following personal rights: To be free from neglect, financial exploitation, involuntary seclusion, punishment, humiliation, intimidation, and verbal, mental, physical, or sexual abuse.
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Executive Director shall conduct staff training in Title 22 Personal Rights 87468, 87468.1, & 87468.2 and will submit training log with staff signatures.

Submit proof of staff training.
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Based on interviews, on 5/30/24 former staff (S10) handled Memory Care Unit resident (R2) in a rough manner by grabbing arm which caused bruising, instead of using redirection techniques. S10 was terminated. This posed a potential health and safety risk to the resident in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Lisa Hicks
LICENSING EVALUATOR NAME: Noemi Galarza
LICENSING EVALUATOR SIGNATURE:

DATE: 03/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/14/2025
LIC9099 (FAS) - (06/04)
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