306002482-10-10-2022-22-AS-LMOA-D2X4Z5-20240229183206

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306002482
Report Date: 10/10/2022
Date Signed: 10/10/2022 04:27:38 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, 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
10/04/2022 and conducted by Evaluator Claudia Gutierrez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20221004145131

FACILITY NAME:	CAREWELL MANOR		FACILITY NUMBER:	306002482
ADMINISTRATOR:	CAROL WILSON		FACILITY TYPE:	740
ADDRESS:	3330 W. STONYBROOK DRIVE		TELEPHONE:	(714) 827-8520
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92804
CAPACITY:	6	CENSUS: 3	DATE:	10/10/2022
		UNANNOUNCED	TIME BEGAN:	10:14 AM
MET WITH:	Carol Wilson		TIME COMPLETED:	04:42 PM

ALLEGATION(S):

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Facility does not have hot running water for the residents' personal care.

Facility does not maintain a comfortable temperature for residents due to a lack of air conditioning.

INVESTIGATION FINDINGS:

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An unannounced Complaint Investigation was conducted on this day by Licensing Program Analyst (LPA) Claudia Gutierrez regarding the allegation mentioned above. LPA met with Administrator (AD) Carol Wilson and took a guided tour of the facility.

Complaint alleges facility does not have hot running water for the residents' personal care and facility does not maintain a comfortable temperature for residents due to a lack of air conditioning.

LPA interviewed AD regarding the allegation facility does not have hot running water for the residents’ personal care. AD stated the facility currently has and always had hot running water. LPA tested the water temperature in two out of two resident bathrooms. Water tested between 105.0-105.4 degrees Fahrenheit. Per California Code of Regulations 87303(e)(2) Faucets used by residents for personal care shall deliver hot water. (Cont. LIC 9099-C)

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Claudia Gutierrez	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2022

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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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
10/04/2022 and conducted by Evaluator Claudia Gutierrez

COMPLAINT CONTROL NUMBER: 22-AS-20221004145131

FACILITY NAME:	CAREWELL MANOR		FACILITY NUMBER:	306002482
ADMINISTRATOR:	CAROL WILSON		FACILITY TYPE:	740
ADDRESS:	3330 W. STONYBROOK DRIVE		TELEPHONE:	(714) 827-8520
CITY:	ANAHEIM	STATE: CA	ZIP CODE:	92804
CAPACITY:	6	CENSUS: 3	DATE:	10/10/2022
		UNANNOUNCED	TIME BEGAN:	10:14 AM
MET WITH:	Carol Wilson		TIME COMPLETED:	04:42 PM

ALLEGATION(S):

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Caregiving staff has not received the required training including but not limited to CPR training.

INVESTIGATION FINDINGS:

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An unannounced Complaint Investigation was conducted on this day by Licensing Program Analyst (LPA) Claudia Gutierrez regarding the allegation mentioned above. LPA met with Administrator (AD) Carol Wilson and took a guided tour of the facility.

An interview was conducted with AD regarding the allegation caregiving staff has not received the required training including but not limited to CPR training. AD stated all caregiving staff completes a 20-hour staff in-service training on a yearly basis and all staff CPR training is up to date. LPA reviewed and obtained a picture of four out of four staff CPR cards. All cards were found to be current and unexpired. LPA also reviewed and obtained a picture of staff in-service training logs signed and dated 1/10/2022.

The department has investigated the complaint alleging caregiving staff has not received the required training including but not limited to CPR training. Per records obtained, interviews conducted, and observations made, we have found that the complaint was unfounded, meaning that the allegation was false, could not have happened and or is without a reasonable basis.

Unfounded

Estimated Days of Completion: 90

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Claudia Gutierrez	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2022

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-20221004145131

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: CAREWELL MANOR	FACILITY NUMBER: 306002482
	VISIT DATE: 10/10/2022

NARRATIVE

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Hot water temperature controls shall be maintained to automatically regulate the temperature of hot water used by residents to attain a temperature of not less than 105-degree F (41 degree C).

Interviews were conducted with AD, Resident 2 (R2) and R1’s responsible party regarding the allegation facility does not maintain a comfortable temperature for residents. Per AD the facility maintains open airways and a fan is always running on days when the temperature is warm. LPA observed multiple fans throughout the facility, with at least one running the entire duration of the visit. AD also stated that a wall air condition unit is used to cool the facility. LPA observed and tested the wall air condition unit located next to the dining room area. Unit was found to be operable. R2 stated the temperature in their bedroom is good and a “little cool.” R1’s responsible party stated the facility is always a comfortable temperature due to open airways allowing for a “cool breeze.” LPA tested the room temperature in the dining area at 11:16 a.m., temperature tested at 75.7 degrees Fahrenheit. LPA again tested the room temperature in the dining area at 1:30 p.m., temperature tested at 78.2 degrees Fahrenheit. At 2:22 p.m. LPA tested the room temperature in R1’s bedroom, temperature tested at 78.8 degrees Fahrenheit. LPA then tested R2 and R3’s bedroom temperature which tested at 78.2 degrees Fahrenheit.

Due to information received during interviews conducted, and after review and observation of the facility LPA is unable to determine if facility did not have hot running water for the residents' personal care and if facility does not maintain a comfortable temperature for residents due to a lack of air conditioning.

This agency has investigated the complaint alleging facility does not have hot running water for the residents' personal care and facility does not maintain a comfortable temperature for residents due to a lack of air conditioning. Although the above allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore at this time the above allegation is unsubstantiated.

An exit was conducted with AD. A copy of this report was provided at the end of the visit.

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Claudia Gutierrez	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2022

LIC9099 (FAS) - (06/04)

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