198603504-2-9-2023-28-AS-RORN-CRAL74-20230427082939

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603504
Report Date: 02/09/2023
Date Signed: 02/09/2023 02:31:58 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
01/31/2023 and conducted by Evaluator Noemi Galarza

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20230131115153

FACILITY NAME:	LA POSADA		FACILITY NUMBER:	198603504
ADMINISTRATOR:	DIANA BAUTISTA		FACILITY TYPE:	740
ADDRESS:	8120 PAINTER AVE		TELEPHONE:	(562) 945-2651
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90602
CAPACITY:	114	CENSUS: 83	DATE:	02/09/2023
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Diana Bautista,		TIME COMPLETED:	11:30 AM

ALLEGATION(S):

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Facility failed to provide resident records.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Galarza conducted an initial 10-Day complaint visit to investigate the above allegation.The purpose of the visit was discussed with Business Office Manager Andrea Lopez. Administrator Diana Bautista arrived shortly after.

The investigation consisted of the following: A tour of the facility was conducted. No health and safety concerns were observed. Licensee and Administratror were interviewed. Resident (R1's) file was reviewed. The following documents were obtained pertaining to R1: Identification and Emergency Information/Face Sheet, Admission Agreement, Physician Report, Pre-Placement Appraisal Information, Resident Appraisals, Appraisal/Needs and Services Plan, Admission Agreement, Advance Healthcare Directive, ALW ISP, Fall risk evaluation, LIC 500 Personnel Report, and resident roster.

See LIC 9099C for report continuation.

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: 02/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023

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-20230131115153

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: 02/09/2023

NARRATIVE

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Allegation: Facility failed to provide resident records. It is alleged that on Thursday, January 26, 2023, the facility received a formal records request via Federal Express to obtain a copy of resident (R1's) records. The request was made by the resident's legal representative. As of of Tuesday, January 31, 2023 the documents had not been provided. They were due Monday, January 30, 2023. Licensee and Administrator confirmed the records request was received on January 26, 2023. Administrator stated that documents were provided to Licensee on January 27, 2023. Licensee stated that they were emailed within 2 days to the requestor, but they were emailed to the wrong email address. Licensee was not able to recall when they contacted the requestor to inform them that they were sent to the wrong email address. The records were sent to the requestor on Thursday February 2, 2023.

Residents of residential care facilities for the elderly shall have prompt access to review all of their records and to purchase photocopies. Photocopied records shall be promptly provided, not to exceed two business days. Based on record review, the findings indicate that the facility provided the documents until Thursday, February 2, 2023, 5 business days later. Therefore, there is sufficient evidence to corroborate the allegation.

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 according to Title 22, Division 6 Health and Safety Code, Chapter 3.2 Residential Care Facilities for the Elderly Article 02.5 Resident's Bill of Rights. See LIC 9099D.

Exit interview was conducted with Administrator Diana Bautista. A copy of the report and appeal rights were provided.

SUPERVISOR'S NAME: Lisa Hicks	TELEPHONE: (323) 981-3972
LICENSING EVALUATOR NAME: Noemi Galarza	TELEPHONE: (323) 981-3974
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20230131115153

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: 02/09/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/16/2023 Section Cited HSC 1569.269(a)(21)	1 2 3 4 5 6 7	Enumerated rights; severability. Residents of residential care facilities for the elderly shall have all of the following rights: To have prompt access to review all of their records and to purchase photocopies. Photocopied records shall be promptly provided, not to exceed two business days, at a cost not to exceed the community standard for photocopies. This requirement was not met evidenced by:	1 2 3 4 5 6 7	Administrator agreed to submit a written plan of correction addressing resident records, enumerated rights; severability, and facility procedures regarding resident records request. Submit by POC due date.
	8 9 10 11 12 13 14	Based on record review, the facility received a formal medical records request on Jan. 26, 2023 and failed to provide the records within 2 business days, as required per regulation; which poses 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: 02/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023

LIC9099 (FAS) - (06/04)

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