198603694-7-11-2024-28-AS-DSIS-D7AVL8-20240718163130

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198603694
Report Date: 07/11/2024
Date Signed: 07/11/2024 01:42:18 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
07/02/2024 and conducted by Evaluator Tena Herrera

PUBLIC

COMPLAINT CONTROL NUMBER: 28-AS-20240702153715

FACILITY NAME:	LEISURE LIVING HOMES, THE		FACILITY NUMBER:	198603694
ADMINISTRATOR:	HECHANOVA, MARJORIE		FACILITY TYPE:	740
ADDRESS:	1738 FINECROFT DRIVE		TELEPHONE:	(818) 400-4667
CITY:	CLAREMONT	STATE: CA	ZIP CODE:	91711
CAPACITY:	6	CENSUS: 4	DATE:	07/11/2024
		UNANNOUNCED	TIME BEGAN:	09:19 AM
MET WITH:	Marjorie Hechanova (Administrator)		TIME COMPLETED:	01:50 PM

ALLEGATION(S):

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Unlawful eviction.
Facility staff as is acting as substitute payee for resident.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Tena Herrera conducted unannocuned compliant visit to investigate the allegations listed above. LPA was greeted by Semon Orbe (caregiver) and was later met by Marjorie Hechanova (Administrator) who assisted with the visit.

The Investigation consisted of the following:
LPA obtained copies of resident and staff rosters, reviewed R1's file and obtained relevant copies of documents within file, toured R1's bedroom and conducted interviews with staff at hospitals, facility administrator and 1 staff at facility.

(continued on 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: David Sicairos	TELEPHONE: (323) 981-3982
LICENSING EVALUATOR NAME: Tena Herrera	TELEPHONE: 323-980-4633
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2024

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-20240702153715

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: LEISURE LIVING HOMES, THE	FACILITY NUMBER: 198603694
	VISIT DATE: 07/11/2024

NARRATIVE

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The investigation revealed the following:
Allegation: Unlawful eviction.
It is alleged that S1 has disclosed that they will not be allowing R1 back into the facility following a recent hospitalization. Per conversations with hospital staff, in which R1 has/had been hospitalized, S1 initially stated they will not be re-admitting R1 to facility upon discharge, however, recently S1 is now stating that they will need to reassess R1 prior to readmission. Per conversation with S1 they denied the above allegation and stated they have not evicted R1, nor have they submitted any eviction paperwork to Licensing. S1 stated that they will be reassessing R1 and make a determination on how to proceed following the reassessment. LPA provided S1 with information under Title 22 regulations for Reappraisals and explained to S1 that although R1 may not be fit for facility after discharge the facility must comply with Title 22 regulations and find a higher level of care for R1 if need be. S1 stated that if it is deemed that R1 will need a higher level of care they will work with R1's doctor to find proper placement for R1. LPA further explained to S1 that once R1 is ready to be discharged from hospital, the reassessment can be done after discharge, as there seems to be some trouble receiving documents needed for the reassessment. LPA also toured R1's room, this is a shared room, R1's bed is still vacant and R1 has their belongings in dresser within room.

Allegation: Facility staff as is acting as substitute payee for resident.
It is alleged that S1 has become R1’s payee and will be collecting funds for the month of August even though R1 will not be admitted back to the facility after their hospitalization. LPA interviewed S1 and S1 denied the above allegation, stating that when R1 was admitted to facility both S1 and R1 went to social security to designate S1 as the payee (which was agreed between family, R1 and S1), however, S1 has placed a hold on the paperwork for R1's family to be designated as the payee since then. S1 stated this was done as they feel the family is a better fit to be the designated payee. LPA spoke with sisters of R1 and it was agreed that family will be the payee for R1.

Based on statements and interviews conducted with staff, and review of R1's file, 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. Exit interview held, and a copy of this report will be provided via email to Administrator Marjorie Hechanova this evening.

SUPERVISOR'S NAME: David Sicairos	TELEPHONE: (323) 981-3982
LICENSING EVALUATOR NAME: Tena Herrera	TELEPHONE: 323-980-4633
LICENSING EVALUATOR SIGNATURE:	DATE: 07/11/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/11/2024

LIC9099 (FAS) - (06/04)

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