306004456-12-5-2023-28-AS-RORN-CYGQ3G-20231213104841

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004456
Report Date: 12/05/2023
Date Signed: 12/05/2023 02:32:25 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 LUREN		FACILITY NUMBER:	306004456
ADMINISTRATOR:	BRIAN BUENVIAJE		FACILITY TYPE:	735
ADDRESS:	13749 E. CREWE STREET		TELEPHONE:	(562) 941-3813
CITY:	WHITTIER	STATE: CA	ZIP CODE:	90605
CAPACITY:	62	CENSUS: 63	DATE:	12/05/2023
		UNANNOUNCED	TIME BEGAN:	01:15 PM
MET WITH:	Bryan Buenviaje – Administrator		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Staff were not aware of resident's whereabouts while in care.

INVESTIGATION FINDINGS:

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*THIS REPORT SUPERSEDES REPORT DATED 10/05/2023 TO ADD ADDITIONAL INFORMATION*
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). On 12/05/23, LPA Mora interviewed Staff 2 (S2) and Client 1 (C1) (a Chinese translator assisted with C1's interview ).

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.
(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: 12/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2023

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-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: 12/05/2023

NARRATIVE

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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. 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. Interview with S2 revealed that S2 does recall that C1 notified the staff that C1 was going to step out of the facility, but when C1 did not return during the usual time, the staff went out looking for C1 and could not find C1. S2 stated C1 has left the facility and safely returned in prior to this incident. Interview with C1 revealed that C1 always let the staff know when C1 is stepping out of the facility and on this day C1 did get lost on the way back to the facility. On the day of the incident, all C1 remembers is that a police officer approached C1 due to C1 having pain on the right side of the stomach and the police sent C1 to the hospital. 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: 12/05/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2023

LIC9099 (FAS) - (06/04)

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