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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198603505
Report Date: 12/19/2023
Date Signed: 12/19/2023 02:28:23 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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 Bennette Pena
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20230602094335
FACILITY NAME:REM CALIFORNIA, LLC - GLENWOODFACILITY NUMBER:
198603505
ADMINISTRATOR:PARRA, DENISEFACILITY TYPE:
735
ADDRESS:2418 GLENWOOD PLACETELEPHONE:
(323) 249-8299
CITY:SOUTH GATESTATE: CAZIP CODE:
90280
CAPACITY:4CENSUS: 3DATE:
12/19/2023
UNANNOUNCEDTIME BEGAN:
10:08 AM
MET WITH:Vanessa Vasquez - Program Director
Guadalupe Cortes, Program Supervisor		TIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Facility staff psychologically/mentally abused resident.
Facility staff did not assist resident with care needs.
Staff did not ensure facility is kept free of mold.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced subsequent complaint visit regarding the above allegations. LPA met with Lisa Renee Clark, Direct Support Professional, Guadalupe Cortes, Program Supervisor and Vanessa Vasquez, Program Director and explained the purpose of the visit.
The investigation consisted of the following: On 06/09/2023, LPA Pena conducted the unannounced initial visit and requested copies of Client & Staff Rosters, the exterminator service invoices, list and contact information of night shift (NOC) staff, Client #1 (C1) - Client #2 (C2) files such as: Identification and Emergency Information Sheet, Physician Report, IPP from Harbor Regional Center, and Incident Reports for the months of March, April & May 2023.
On 09/12/2023, LPA Pena conducted the subsequent unannounced visit and obtained copies of Client & Staff Rosters, the exterminator service invoices, Client #1 (C1) files such as: Identification and Emergency Information Sheet, Physician Report (5/14/2023), Medical Appointment Form (4/21/2022 & 6/13/2023), IPP from Harbor Regional Center (3/16/2023), Medical Appointment calendar for C1 (Jan-Aug 2023) and Incident Reports for the months of March, April & May 2023. LPA also interviewed Staff #1 (S1) - Staff #4 (S4) and Client #3 (C3). At that time, LPA was not able to interview Client #1 (C1) - Client #2 (C2) as they were out in the community.
During today's visit, LPA obtained copies of Client & Staff Rosters, Staff training for Client Rights, Zero Tolerance, Mandated Reporting, C1's Medical appointments (5/25/2021 & 06/08/2023) and exterminator service invoices (Oct.2023-Dec.2023). LPA interviewed Client #1 (C1)-Client #2 (C2) and Staff #5 (S5) telephonically. ***CONTINUED ON LIC9099-C*****
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Bennette Pena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023
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 10
Control Number 28-AS-20230602094335
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: REM CALIFORNIA, LLC - GLENWOOD
FACILITY NUMBER: 198603505
VISIT DATE: 12/19/2023
NARRATIVE
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The investigation revealed the following:

· In regards to the allegation: “Facility staff psychologically/mentally abused resident,” it is alleged that staff was talking and treating a client rudely and being abused by the nighttime staff. Interviewed staff members denied the allegation. Staff members stated that they treat all clients with respect and do not psychologically or mentally abuse clients. Interviewed staff indicated they have not seen or observed staff abusing clients in any way. (2) out of (5) staff members interviewed indicated that they heard that a former staff was not being very helpful to other staff but did not hear anything about abusing clients. Staff also stated that all the staff help each other and assist clients. Staff indicated that C1 needs help with his daily routine and staff encourage C1 to be a little independent. Interviewed staff also indicated that they are trained in Client Rights, Zero Tolerance and Mandated Reporting. Interviewed clients indicated that staff are not psychologically or mentally abusive to them. Clients interviewed stated that they have not witnessed any staff abusing other clients in care. Clients also stated that staff in the facility are good to them and treat them properly. Documentation reviewed, Staff and Client interviews do not corroborate this allegation.

· In regards to the allegation: “Facility staff did not assist resident with care needs,” it is alleged that the staff do not want to help a client because of his medical condition and not working with the client appropriately. Interviewed staff members denied the allegation. S1 stated that no one has reported this to her and had not heard this complaint before. S1 has not witnessed or heard staff not assisting clients with their care needs. Staff members stated that they assist all the clients with their day-to-day needs. Staff also stated that all the staff help each other most of the time. Staff stated that their main responsibility is to provide care for the clients. Staff stated that their daily routine includes giving them showers, putting on their clothes, preparing food and giving them their medication. Interviewed staff also indicated that they encourage clients to be independent. And if the clients do not finish their tasks, the staff finish it for them. Staff members stated that they have never heard or seen other staff being unhelpful to the clients with their care needs. Interviewed clients indicated that staff help them with their daily activities. Clients interviewed stated that they have not witnessed any staff not assisting clients when they need help. Clients also stated that the staff take good care of them. LPA reviewed the staff’s daily schedule and notes indicating that the staff provide care to the clients. Staff interviews, client interviews and reviewed documentation do not corroborate this allegation.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Bennette Pena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 10
Control Number 28-AS-20230602094335
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: REM CALIFORNIA, LLC - GLENWOOD
FACILITY NUMBER: 198603505
VISIT DATE: 12/19/2023
NARRATIVE
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  • In regards to the allegation: “Staff did not ensure facility is kept free of mold.” It is alleged that facility has mold problems with a large "pool" under the home. Interviewed staff stated that this is the first time they have heard about mold problems. Although staff interviewed stated that they are aware of the plumbing issues, they indicated that they have not seen mold in the facility. S1 stated that the plumbing issue was underneath the home but S1 has not seen mold. Interviewed staff stated that they will report seeing mold immediately because it is unsafe and can cause many health effects to staff and clients. Clients interviewed stated that they have not seen mold anywhere and have never noticed or heard other clients complaining about mold. During LPA’s tour of the physical plant on 06/09/2023, 09/12/2023 and 12/19/2023, LPA did not observe any signs of mold in the entire facility. Therefore, there was insufficient evidence to corroborate the allegation.

    • Based on statements and interviews conducted with staff, clients, review of resident files and facility file records, there was not enough supportive evidence to concur with the reported allegations. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Bennette Pena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 10
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 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 Bennette Pena
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20230602094335

FACILITY NAME:REM CALIFORNIA, LLC - GLENWOODFACILITY NUMBER:
198603505
ADMINISTRATOR:PARRA, DENISEFACILITY TYPE:
735
ADDRESS:2418 GLENWOOD PLACETELEPHONE:
(323) 249-8299
CITY:SOUTH GATESTATE: CAZIP CODE:
90280
CAPACITY:4CENSUS: 3DATE:
12/19/2023
UNANNOUNCEDTIME BEGAN:
10:08 AM
MET WITH:Vanessa Vasquez - Program Director
Guadalupe Cortes, Program Supervisor		TIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Staff did not ensure resident is seen by their medical provider as scheduled.
Staff did not ensure facility is kept free of pests.
Facility is in disrepair.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Bennette Pena conducted an unannounced subsequent complaint visit regarding the above allegations. LPA met with Lisa Renee Clark, Direct Support Professional, Guadalupe Cortes, Program Supervisor and Vanessa Vasquez, Program Director and explained the purpose of the visit.
The investigation consisted of the following: On 06/09/2023, LPA Pena conducted the unannounced initial visit and requested copies of Client & Staff Rosters, the exterminator service invoices, list and contact information of night shift (NOC) staff, Client #1 (C1) - Client #2 (C2) files such as: Identification and Emergency Information Sheet, Physician Report, IPP from Harbor Regional Center, and Incident Reports for the months of March, April & May 2023.
On 09/12/2023, LPA Pena conducted the subsequent unannounced visit and obtained copies of Client & Staff Rosters, the exterminator service invoices, Client #1 (C1) files such as: Identification and Emergency Information Sheet, Physician Report (5/14/2023), Medical Appointment Form (4/21/2022 & 6/13/2023), IPP from Harbor Regional Center (3/16/2023), Medical Appointment calendar for C1 (Jan-Aug 2023) and Incident Reports for the months of March, April & May 2023. LPA also interviewed Staff #1 (S1) - Staff #4 (S4) and Client #3 (C3). At that time, LPA was not able to interview Client #1 (C1) - Client #2 (C2) as they were out in the community.
During today's visit, LPA obtained copies of Client & Staff Rosters, Staff training for Client Rights, Zero Tolerance, Mandated Reporting, C1's Medical appointments (5/25/2021 & 06/08/2023) and exterminator service invoices (Oct.2023-Dec.2023). LPA interviewed Client #1 (C1)-Client #2 (C2) and Staff #5 (S5) telephonically. ***CONTINUED ON LIC9099-C*****
Substantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Bennette Pena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 10
Control Number 28-AS-20230602094335
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: REM CALIFORNIA, LLC - GLENWOOD
FACILITY NUMBER: 198603505
VISIT DATE: 12/19/2023
NARRATIVE
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  • In regards to the allegation: “Staff did not ensure resident is seen by their medical provider as scheduled.” It is alleged that a client is to see a psychiatrist every 3 months but learned that the client has not seen the psychiatrist for over 2 years. S1 stated that this allegation is so true. S1 indicated that she took over the position in June and discovered that a lot of clients’ appointments were missed. S1 indicated however that they are now caught up with all the clients’ medical and dental appointments and back on a regular schedule. S2-S4 also corroborated S1’s statement and stated that C1’s medical appointments fell through the cracks. S3 stated that she was cleaning up and going through the clients’ files and saw that C1’s form was in the cabinet which showed that C1 had missed his doctors’ appointments. S3 reported it to the former Administrator and staff called to make an appointment for C1. However, C1 has an outstanding balance with the doctor which the family members settled. S4 stated that appointments were being made for C1 but C1 was not going to the doctor. S4 also indicated that whoever was doing the schedule was not doing a good job. Clients interviewed indicated that they remember going to their doctors by the staff. C4 stated that she was doing her own dental appointment when her insurance ran out. LPA reviewed documentation indicating that the last time C1 had seen his doctor was 05/25/2021. Following that medical appointment was not until 06/08/2023. Documentation reviewed and interviews conducted with staff and clients corroborate this allegation.

  • In regards to the allegation: “Staff did not ensure facility is kept free of pests.” It is alleged that cockroaches were noted and have not been eradicated. Additionally, it is alleged that clients have been temporarily moved out at least 3 times for the interim to another home. S1 concurred with the allegation and stated that she has seen roaches at least 2x. All staff interviewed stated that they have seen cockroaches in the hallway and in the kitchen. Staff interviewed stated that the exterminator came to spray, but the cockroaches were not going away. Staff interviewed indicated that before the plumbing issue was fixed, they saw cockroaches every time. But now that the plumbing has been fixed and the house has been remodeled, they have not seen cockroaches or any type of pests around. Clients interviewed stated that they have seen cockroaches in the kitchen and hallway, not much in their bedrooms. LPA reviewed the correspondence from the former Administrator dated 04/21/2023 and 04/25/2023 indicating their plan to temporarily relocate the clients and staff to another home due to an identified roach infestation of the home. LPA also reviewed an incident report submitted by the Area Director dated 05/19/2023 indicating that the clients will have to relocate once again because they discovered that the roach issue had returned. Therefore, there was sufficient evidence to corroborate the allegation.
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Bennette Pena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023
LIC9099 (FAS) - (06/04)
Page: 7 of 10
Control Number 28-AS-20230602094335
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: REM CALIFORNIA, LLC - GLENWOOD
FACILITY NUMBER: 198603505
VISIT DATE: 12/19/2023
NARRATIVE
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  • In regards to the allegation: “Facility is in disrepair.” it is alleged that since October 2022, the facility has plumbing issues (sewer line leaking). All staff interviewed confirmed that the facility had on-going plumbing issues. (4) out of (5) staff interviewed stated that the back bathroom toilet was clogged every other day. Although the maintenance worker came to the facility often to fix it, within a day or two, the toilet was clogged again. Eventually, staff stated that they had to lock the back bathroom and use only (1) bathroom for the clients and staff. Interviewed staff also stated that clients and staff were relocated to a different home due to plumbing issues which also caused the roach infestation. Staff indicated that when plumbers were working underneath the home, the roaches made their way out and inside the home. Staff also indicated that REM hired their own plumber to fix the issues and had to wait for the parts needed, which took a while. Interviewed clients stated that they were aware of the broken toilet in the back bathroom, but they don’t have any problems using the other bathroom. LPA reviewed documentation and communication thread between REM and the home management (Feb. 2023) in regards to the replacement of old leaking pipes. Therefore, there was sufficient evidence to corroborate the allegation.

    • Based on LPA’s observations, interviews, and record reviews, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Deficiencies cited on the attached LIC 9099D.

    An exit interview was conducted, and a copy of this report was provided to Guadalupe Cortes, Program Supervisor along with the Appeals Rights.

NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Bennette Pena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023
LIC9099 (FAS) - (06/04)
Page: 8 of 10
Control Number 28-AS-20230602094335
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: REM CALIFORNIA, LLC - GLENWOOD
FACILITY NUMBER: 198603505
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/20/2023
Section Cited
CCR
80072(a)(9)
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80072 Personal Rights (a) Except for children’s residential facilities, each client shall have personal rights which include, but are not limited to, the following: (9) To receive or reject medical care, or health-related services, except for minors and other clients for whom a guardian, conservator, or other legal authority has been appointed.
This requirement is not met as evidenced by:
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The licensee shall ensure all clients receive medical care as part of their needs and services plan. The administrator will develop and maintain a plan of correction on how to prevent this incident from happening again. Administrator shall submit the plan to CCL/LPA by POC due date.
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Based on LPA’s interviews, and record reviews, the Administrator did not ensure that C1 is seen by his medical provider as scheduled. C1 did not see his medical provider for 2 years which poses an immediate health and safety risk to clients in care.
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Type A
12/20/2023
Section Cited
CCR
80087(a)(1)
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80087 Buildings and Grounds (a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors. (1) The licensee shall take measures to keep the facility free of flies and other insects.

This requirement is not met as evidence by:
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Facility Administrator to ensure that the facility is kept free of pests and to make arrangements with a professional/commercial Pest Control Company to have the facility inspected and treated for cockroaches and other insects regularly. Facility Administrator to submit a written plan as to how the facility will rectify this deficiency and submit a copy of the Pest Control Contract to LPA by POC due date.
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Based on interviews and records review, the Administrator did not comply with the section cited above in which the staff and clients interviewed admitted seeing cockroaches in the facility many times. This poses an immediate health, safety, and/or personal rights risk to the clients 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.
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Bennette Pena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023
LIC9099 (FAS) - (06/04)
Page: 9 of 10
Control Number 28-AS-20230602094335
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: REM CALIFORNIA, LLC - GLENWOOD
FACILITY NUMBER: 198603505
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/26/2023
Section Cited
CCR
80087(a)
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 80087 Buildings and Grounds (a) The facility shall be clean, safe, sanitary and in good repair at all times for the safety and well-being of clients, employees and visitors.

This requirement is not met as evidenced by:
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Administrator shall ensure that plumbing/fixtures work properly in the facility. Administrator to submit the service report/ invoice indicating the work done to CCL/LPA by POC due date.
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Based on interviews and documentation reviewed, the facility had on-going issues with plumbing and toilet was not working properly which poses a potential health and safety risk to clients 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.
NAME OF LICENSING PROGRAM MANAGER: David Sicairos
NAME OF LICENSING PROGRAM ANALYST: Bennette Pena
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023
LIC9099 (FAS) - (06/04)
Page: 10 of 10