198603648-9-10-2024-28-AS-RORN-DA4QKN-20241016121433

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603648
Report Date: 09/10/2024
Date Signed: 09/10/2024 01:46:52 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
09/05/2024 and conducted by Evaluator Elizabeth Irra

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240905151002

FACILITY NAME:	OMEO ARCADIA LIVING		FACILITY NUMBER:	198603648
ADMINISTRATOR:	ZHANG, JINGFANG		FACILITY TYPE:	740
ADDRESS:	601 SUNSET BLVD		TELEPHONE:	(323) 422-8030
CITY:	ARCADIA	STATE: CA	ZIP CODE:	91007
CAPACITY:	99	CENSUS: 78	DATE:	09/10/2024
		UNANNOUNCED	TIME BEGAN:	08:10 AM
MET WITH:	Lucy Angel/Administrator Assistant		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff is not administering medications as prescribed.
Staff is not obtaining medication refills timely.
Staff did not respond to resident's call button for assistance.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Elizabeth Irra conducted a visit to investigate the above allegations. LPA met with Lucy Angel/S1-Assistant Administrator and Jennifer Lan/S1- Administrator and discussed the purpose of today’s visit.

During this visit, LPA obtained a copy of the resident and staff rosters, reviewed files for Resident #1 (R-1) through Resident #8 (R-8) and obtained relevant documentation, copies of pendant call logs, interviewed Staff #1 (S-1) through Staff #5 (S-5) and interviewed Resident #2 (R-2) through Resident #8 (R-8). LPA was unable to interview Resident #1 (R-1) as R-1 was not present during this visit. LPA also attempted to contact R-1 and was unsuccessful.

Refer to LIC 9099C for the continuation of this report.

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024

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-20240905151002

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: OMEO ARCADIA LIVING	FACILITY NUMBER: 198603648
	VISIT DATE: 09/10/2024

NARRATIVE

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Staff is not administering medications as prescribed. It was alleged that a resident did not get morning medications until 10:30 A.M.-10:45 A.M. some days. Staff interviews revealed that medications are administered as prescribed and are provided to residents timely and on a routine basis. Interviewed staff indicated that R-1 is independent and will go out in the community without informing staff and will return to request their medication. Interviewed staff indicated they have not received any complaints regarding this matter. Resident interviews revealed that they receive their medication in a timely manner. Interviewed residents indicated they do not have any concerns regarding this matter. Interviews do not corroborate this allegation.

Staff is not obtaining medication refills timely. It was alleged that the facility staff does not obtain the resident’s medication refill on time and is asked to contact the pharmacist or doctor to obtain the refill for them. Staff interviews revealed that staff are responsible for requesting residents’ refills through the pharmacy and/or physicians. Interviewed staff indicated that R-1 has prescribed medications for pain management (as needed) in which R-1 contacts their physician directly for refills (per R-1’s choice). Per staff interviews, staff handle R-1’s other medication refills and at times assist R-1 with their pain management medication refill. Interviewed staff indicated they have not received any complaints regarding this matter. Resident interviews revealed that staff obtain their medication refills in a timely manner. Interviewed residents indicated that staff are responsible for requesting refills through the pharmacy and/or making contact with the prescribing physician. Interviewed residents indicated they do not have any concerns regarding this matter. Interviews and reviewed documentation do not corroborate this allegation.

Staff did not respond to resident's call button for assistance. It was alleged that staff do not respond to residents’ call buttons/pendants in a timely manner. Staff interviews revealed that staff respond to residents’ call button for assistance in a timely manner (not wait until the end of their shift to respond). Interviewed staff indicated that rounds are also conducted routinely. Staff interviews indicated they have not received any complaints regarding this matter. Resident interviews revealed that staff respond to their call buttons/pendant in a timely manner. Interviewed residents indicated they do not have any concerns regarding this matter. Interviews and reviewed documentation do not corroborate this allegation.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview conducted, appeal rights and a copy of this report was provided to Jennifer Lan.

NAME OF LICENSING PROGRAM MANAGER: Tony Vasallo
NAME OF LICENSING PROGRAM ANALYST: Elizabeth Irra
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024

LIC9099 (FAS) - (06/04)

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