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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 306004456
Report Date: 10/05/2023
Date Signed: 10/05/2023 03:35:37 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
09/28/2023 and conducted by Evaluator Luis Mora
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20230928155535
FACILITY NAME:VILLA LURENFACILITY NUMBER:
306004456
ADMINISTRATOR:BRIAN BUENVIAJEFACILITY TYPE:
735
ADDRESS:13749 E. CREWE STREETTELEPHONE:
(562) 941-3813
CITY:WHITTIERSTATE: CAZIP CODE:
90605
CAPACITY:62CENSUS: 63DATE:
10/05/2023
UNANNOUNCEDTIME BEGAN:
01:06 PM
MET WITH:Bryan Buenviaje – AdministratorTIME COMPLETED:
03:50 PM
ALLEGATION(S):
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Staff were not aware of resident's whereabouts while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Luis Mora conducted an unannounced initial complaint visit to determine the validity of the above-mentioned allegation. LPA met with Bryan Buenviaje and explained the reason for the visit.

The investigation consisted of the following: LPA Mora obtained copies of staff and client rosters, C1's physician report and missing person police report. LPA interviewed Administrator, Staff 1 (S1), and attempted to interview Staff 2 - Staff 3 (S2 - S3) and Client 1 (C1).

The investigation revealed the following: regarding the allegation "staff were not aware of resident's whereabouts while in care”, it is alleged that the C1 left the facility without anyone knowing or informing anyone. Administrator stated that when the staff did their rounds in the evening of 09/24/23 they could not find C1. Staff drove around the liquor because C1 tends to go to the liquor, but couldn't find C1. S1 filed a missing person report the following morning. Administrator stated that they kept looking for the client the following days and checked with hospitals, but couldn't find C1. (Continued to LIC 9099-C)
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Luis Mora
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 28-AS-20230928155535
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: VILLA LUREN
FACILITY NUMBER: 306004456
VISIT DATE: 10/05/2023
NARRATIVE
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On 09/28/23, the facility was contacted by a hospital and the client was discharged back to the facility. Administrator stated that the hospital had the wrong client information and that is why when they checked with that hospital they told the facility that they did not have anyone with C1's name. Administrator also stated that the client was found in front of some apartment complex and someone called the police. The police took C1 to the hospital. Administrator believes C1 might have taken a wrong turn and got lost because C1 has gone out to the liquor in the past and returned to the facility. The LPA was unable to interview C1 due to a language barrier and no translators were present. C1's physician report shows that C1 is non-ambulatory and uses a wheelchair due to right side weakness, has no dementia, and it states that C1 is able to leave the facility unassisted. The facility did their due diligence in looking for the client and filing a missing person report.

Although the 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 the allegation is unsubstantiated.

Exit interview held and a copy of the report was provided
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Luis Mora
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 10/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2