300613262-8-7-2020-22-AS-SSAS-BSE2GG-20200811172303

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 300613262
Report Date: 07/24/2020
Date Signed: 08/07/2020 08:34:30 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/28/2020 and conducted by Evaluator James August

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20200528144536

FACILITY NAME:	NEW ERA GUEST HOME		FACILITY NUMBER:	300613262
ADMINISTRATOR:	GUTIERREZ, JOSEFINA P.		FACILITY TYPE:	740
ADDRESS:	12692 BLACKTHORN ST.		TELEPHONE:	(714) 537-1282
CITY:	GARDEN GROVE	STATE: CA	ZIP CODE:	92840
CAPACITY:	6	CENSUS: 4	DATE:	07/24/2020
		UNANNOUNCED	TIME BEGAN:	12:29 PM
MET WITH:	Administrator Josefina Gutierrez		TIME COMPLETED:	12:50 PM

ALLEGATION(S):

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Staff are not meeting showering needs of residents
Facility does not provide quality food to residents in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jim August contacted the facility via telephone to conclude a complaint investigation via telephone due to COVID-19 and precautionary measures. LPA identified himself and discussed the purpose of the call with Administrator Josefina Gutierrez.

The 10-day facility visit was completed on June 3, 2020. The investigation into the allegations that the facility staff are not meeting the showering needs of the resident and staff are not providing quality food service revealed the following:
LPA August conducted interviews with Administrator Josefina Gutierrez, two (2) staff members, three (3) residents, four (4) witnesses as well as obtained and reviewed records from the facility.
Witness 1 (W1) alleged that resident 1 (R1) was not receiving quality food service from the facility and that the facility was failing to meet the showering needs of R1. LPA August interviewed Staff 1 (S1) and Staff 2 (S2). Both S1 and S2 corroborated that they provided showers and or baths to R1 three times a week and sufficiently met R1’s needs. CONTINUED ON LIC9099 DATED 8/7/2020.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Marina Stanic	TELEPHONE: (714) 703-2857
LICENSING EVALUATOR NAME: James August	TELEPHONE: 714-703-2853
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2020

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 22-AS-20200528144536

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: NEW ERA GUEST HOME	FACILITY NUMBER: 300613262
	VISIT DATE: 07/24/2020

NARRATIVE

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Both S1 and S2 corroborated that they never served residents with spoiled food and that most meals were freshly made. In addition, S1 and S2 stated that the facility catered to residents needs and preferred meals. Neither S1 or S2 were ever told by anyone that the food served to the residents was of poor quality or quantity. Administrator Gutierrez stated that the facility does not ever serve spoiled or poor quality food and that most meals are fresh and catered towards residents preferences. Administrator Gutierrez stated that all residents at the facility get a shower or bath three times a week.

Witness 2 (W2) and witness 3 (W3) corroborated that they were at the facility often prior to the Covid-19 outbreak and witnessed the food being served to residents. Both W1 and W2 indicated that the food was good quality and quantity and neither heard any complaints about the food or the facility failing to meet the needs of residents for showers. W1 and W2 corroborated that residents were getting their showering needs met by the facility. Witness 4 (W4) visits the facility once a week and witnessed the food to be of good quality and quantity.

Resident 2 (R2) stated that R2 received showers daily. In addition, R2 stated that the food was of good quality and never spoiled.

LPA August obtained and reviewed the past four (4) weeks of facility menu’s. The menus provided 3 meals per day and were of a different variety of foods each day.

As such, there is insufficient evidence to corroborate whether the above allegations have occurred. With the information obtained through the means described above, we have found the above allegations unsubstantiated. Although the allegations may have happened or may be valid; there is not a preponderance of evidence to prove that the alleged violations occurred. No deficiencies were observed, and no citations were issued during this visit.

An exit interview was conducted with Administrator Gutierrez via tele-visit and a copy of this report was provided to Administrator Gutierrez via email. Administrator Gutierrez to sign all pages of the report and return the signed copy to LPA August via email within 24 hours.

SUPERVISOR'S NAME: Marina Stanic	TELEPHONE: (714) 703-2857
LICENSING EVALUATOR NAME: James August	TELEPHONE: 714-703-2853
LICENSING EVALUATOR SIGNATURE:	DATE: 07/24/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/24/2020

LIC9099 (FAS) - (06/04)

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