198603648-10-3-2024-28-AS-RORN-D9WT93-20241010143118

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603648
Report Date: 10/03/2024
Date Signed: 10/03/2024 04:13:51 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
09/20/2024 and conducted by Evaluator Jose Villalobos

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240920083750

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: 80	DATE:	10/03/2024
		UNANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:	Administrator Jennifer Zhang		TIME COMPLETED:	04:20 PM

ALLEGATION(S):

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Staff left resident soiled for an extended period of time.
Staff did not answer resident's call button in a timely manner.
Staff did not provide water to resident as requested.
Staff speak to residents in an inappropriate manner
Staff not providing medications to resident as prescribed

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jose Villalobos conducted an unannounced complaint investigation visit for the allegations above. LPA met with administrator Jennifer Zhang and the purpose of the visit was discussed.

Initial visit conducted on 9/26/24 consisted of the following:LPA Villalobos interviewed Resident #1 (R1), interviewed Staff #1-7 (S1-S7), collected copies of the staff and residents roster. LPA also collected documents from R1's file related to the investigation. On todays visit, LPA interviewed Residents #2-7 (R2-R7) and Staff #8 (S8). The investigation revealed the following:

In regards to the allegation "Staff left resident soiled for an extended period of time" it is alleged that on 9/16/24 R1 was left in soiled clothing for an extended period of time. (8) of (8) Staff interviewed denied the allegation. (6) of (7) Residents interviewed could not corroborate the allegation....

Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Jose Villalobos
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024

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-20240920083750

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: OMEO ARCADIA LIVING	FACILITY NUMBER: 198603648
	VISIT DATE: 10/03/2024

NARRATIVE

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Interview with R1 stated that they pressed the call button sometime at night to request assistance with changing clothes before bed but no one arrived. R1 stated to have gone to sleep and woke up in their bed at 2am in soiled clothing. They had to press the button to request help again until S7 arrived at 3am. R1 was not sure how long they were in soiled clothing prior but stated that staff assisted in changing once they arrived. Most staff interviewed denied that any call buttons are ignored or that it takes a long time to respond to call buttons. (1) Staff stated it is possible for calls to be ignored but no specifics were provided. S7 worked the night shift of the incident and denied that they ever took long to respond to R1s call button. S7 stated they arrived to assist R1 within minutes. Before the call button was pressed S7 was not aware of R1 being in soiled clothing as S1 is capable of doing their own toileting needs and is not someone who needs assistance with that. This was the only incident where R1 had soiled themselves. File review shows that R1 does not have a care plan requiring staff to perform grooming or toileting assistance from staff overnight but staff interviewed stated they will perform checks every 2 hours as facility protocol. R1 confirmed that they are independent when it comes to toileting and showering needs. Based on interviews, observations, and file review, 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 violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

In regards to the allegation "Staff did not answer resident's call button in a timely manner." it was alleged that on 9/16/24 R1 pressed their call button and some point during the night, then again at 2am but no one arrived until 3am. (8) of (8) Staff interviewed denied the allegation. (6) of (7) Residents interviewed could not corroborate the allegation. Staff interviews did not show that it takes anywhere up to an hour or more to respond to a residents call button. Average response times are between 5-10 minutes. They can sometimes be a lot quicker or just a bit longer. LPA was informed that the call button system also logs calls for management to review. Residents interviews does not show that there is a long response time from the staff. LPA reviewed the call button log specific to R1 and observed the average wait time to be 7 minutes. LPA randomly tested the response time in several rooms during the visits and observed staff to arrive and answer within 3 minutes each time. Based on interviews, observations, and file review, 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 violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Continued on LIC 9099-C

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Jose Villalobos
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024

LIC9099 (FAS) - (06/04)

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Control Number 28-AS-20240920083750

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: OMEO ARCADIA LIVING	FACILITY NUMBER: 198603648
	VISIT DATE: 10/03/2024

NARRATIVE

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In regards to the allegation "Staff did not provide water to resident as requested." it was alleged that on 9/14/24 R1 requested ice water from S2 and S2 did not provide it. (8) of (8) Staff interviewed denied the allegation. (6) of (7) Residents interviewed could not corroborate the allegation. S2 denied ever refusing to provide R1 or any other resident with water when asked. File review does not show there were notes or logs of incident occurring. LPA was not provided with proof that the incident occurred. Based on interviews, observations, and file review, 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 violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

In regards to the allegation "Staff speak to residents in an inappropriate manner" it was alleged that S8 tried to intimidate R1 to move out. (8) of (8) Staff interviewed denied the allegation. (6) of (7) Residents interviewed could not corroborate the allegation. Details provided were that R1 was intimidated to move out as a option for bringing up issues they were having in the facility. S8 denied ever intimidating the residents in any way. She denied intimidating or pressuring R1 to leave the facility. Staff interviews show that R1 has been verbal about not wanting to live in the facility and would rather go somewhere close to family. R1 confirmed this. Based on interviews, observations, and file review, 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 violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

In regards to the allegation "Staff not providing medications to resident as prescribed" it is alleged that medications are not administered to R1 on time or at all. (8) of (8) staff interviewed denied the allegation. (6) of (7) Residents interviewed could not corroborate the allegation. LPA was not provided with specific dates. Staff interviews revealed that medications are administered as prescribed and are provided to residents timely basis. Interviews with staff and R1 show that R1 is independent and will go out in the community without informing staff for prolongs times and will return to request their medication. There are days they do not return to take the medications on time. Staff stated they cannot provide resident morning medications if it is not morning any longer because afternoon meds are next. File review shows that staff provide R1 their medication as prescribed. Medication log is used and LPA reviewed it. Based on interviews, observations, and file review, 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 violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit Interview conducted and a copy of this report was provided.

NAME OF LICENSING PROGRAM MANAGER: Fernando Fierros
NAME OF LICENSING PROGRAM ANALYST: Jose Villalobos
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 10/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2024

LIC9099 (FAS) - (06/04)

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