198603535-12-3-2024-28-AS-FFIS-DBSW2F-20241209155417

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603535
Report Date: 12/03/2024
Date Signed: 12/03/2024 10:15:45 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 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
10/23/2024 and conducted by Evaluator Sanjay Vaid

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20241023134312

FACILITY NAME:	SANTA ANITA ASSISTED LIVING		FACILITY NUMBER:	198603535
ADMINISTRATOR:	MAYA S MNOYAN		FACILITY TYPE:	740
ADDRESS:	5600 GRACEWOOD AVENUE		TELEPHONE:	(626) 442-8410
CITY:	TEMPLE CITY	STATE: CA	ZIP CODE:	91780
CAPACITY:	150	CENSUS: 147	DATE:	12/03/2024
		UNANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Ruth Villa -Wellness Director		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Staff did not take appropriate steps to prevent the spread of communicable disease.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) S. Vaid conducted a subsequent complaint visit regarding the allegation listed above to deliver findings for the investigated complaint. Met with Wellness Director Ruth Villa. LPA didnot observe any health and safety concerns.

On 10/31/2024, LPA Vaid conducted a 10-day complaint visit to the facility. The investigation consisted of the following: LPA obtained and reviewed staff schedule and client roster, client list of names that are being tracked and isolated, copy of In-Service staff training for Scabies, PPE-gown, and handwashing. LPA interviewed fourteen (14) clients and seven (7) staff. Five (5) Four Tech Laboratory reports for the affect clients.

The investigation revealed the following. Regarding Allegation: Staff did not take appropriate steps to prevent the spread of communicable disease. Seven (7) out of seven (7) staff interviewed stated that one resident had been diagnosed with scabies and three other clients are being tracked for the illness, all the clients have been isolated to their rooms. Continued on 9099C.......

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Sanjay Vaid	TELEPHONE: 916-215-7924
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024

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-20241023134312

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
MONTEREY PARK ASC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754

FACILITY NAME: SANTA ANITA ASSISTED LIVING	FACILITY NUMBER: 198603535
	VISIT DATE: 12/03/2024

NARRATIVE

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The affected clients were educated about the scabies rash and physician and family were informed of the resident’s communicable disease and of the precautions taken, isolation until scabies rash is gone. Four (4) residents were tracked for scabies starting on 10/16/24, 10/17/24 and 10/23/24 for rash and were given Permethrin cream to apply to rash. Staff explains the details of the isolation procedures that are followed to ensure that the Scabies is not spread to other residents. Gowns, gloves, and masks are worn when servicing the isolated clients, PPE are constantly changed after each resident is visited. Fourteen (14) out of fourteen (14) residents interviewed have said that they have observed the staff use gowns, gloves and masks when making their rounds and visiting the isolated residents. Residents interviewed also state that they were told to stay in their rooms if they developed a rash, but some do not listen and wander all around the facility. Clients interviewed state that the staff is doing their very best to keep the facility clean and free from illnesses in the facility. LPA Vaid observed caregivers and Med-tech staff taking extra precautions when delivering services to infected residents. Scabies skin scraping and testing was conducted on 11/04/24. Out of one hundred forty-seven (147) residents, one hundred six (106) residents were tested, fifteen (15) residents refused testing, twenty six (26) residents were out of the facility. From all the residents that were tested only one resident was diagnosed by the physician to have scabies.

Based upon the investigation, interviews conducted with residents and staff, documents collected and reviewed, and observations made by LPA the investigation did not reveal any evidence to support that staff did not take appropriate steps to prevent the spread of communicable disease. 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 allegation is unsubstantiated.

An exit interview was conducted and copy of this report was left with the Wellness Director Ruth Villa.

SUPERVISOR'S NAME: Fernando Fierros	TELEPHONE: (323) 981-3981
LICENSING EVALUATOR NAME: Sanjay Vaid	TELEPHONE: 916-215-7924
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024

LIC9099 (FAS) - (06/04)

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