306004516-5-31-2022-22-AS-SSAS-CHT7E7-20220830213528

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306004516
Report Date: 05/31/2022
Date Signed: 05/31/2022 09:41:24 AM

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
05/05/2022 and conducted by Evaluator Ruth Martinez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20220505150004

FACILITY NAME:	ALPER'S CARE HOME		FACILITY NUMBER:	306004516
ADMINISTRATOR:	ALPER OZDEMIR		FACILITY TYPE:	740
ADDRESS:	12192 MAGNOLIA STREET		TELEPHONE:	(714) 539-3735
CITY:	GARDEN GROVE	STATE: CA	ZIP CODE:	92841
CAPACITY:	6	CENSUS: 4	DATE:	05/31/2022
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Alper Ozdemir		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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-Staff refused to provide water and medications to resident.

-Resident was yelled at by staff.

-Resident was fed Taco Bell for three weeks.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ruth Martinez visited the facility to deliver findings for the investigation into the above identified complaint allegations. LPA arrive at facility was greeted at the door by caregiver and granted entry. LPA spoke with Alper Ozdemir, Administrator and explained the purpose of the visit.

Findings are based upon this investigation which included file review, observed facility food supply and interviews conducted.

It is alleged that staff refused to provide water and medications to resident, resident was yelled at by staff, and resident was fed Taco Bell for three weeks. LPA reviewed medication logs in order to verify medication was being provided. Medication logs revealed that logs have been marked when medication is administered.

Continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Ruth Martinez	TELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022

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-20220505150004

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: ALPER'S CARE HOME	FACILITY NUMBER: 306004516
	VISIT DATE: 05/31/2022

NARRATIVE

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LPA did not find any indications that doses were missed for residents in care. Interviews conducted with residents expressed that they are given a cup of water when they are being given their medication. There were no concerns with residents about obtaining water with their medication or when they requested water in general. Interviews with resident revealed that they are treated well and never get yelled at by any of the staff at the facility. Residents indicated they have never witnessed the staff yelling at any of the residents. R1 indicated that R1 would get yelled at when she was at a former facility, but not at this facility, R1 indicated that staff treats R1 very well. It was observed that there was sufficient amount of quality and quantity of perishable and nonperishable food for residents. In addition, LPA obtained a copy of the facility weekly menu for review and observed the food service to be well balanced with a variety of choices. LPA conducted interviews with residents and expressed no concerns on the quality of the food provided. Interviews indicated that generally, residents have request to eat out at times in which the facility tries to make an effort to accommodate.

Based on the information mentioned above, the Department is unable to ascertain if the allegation occurred as reported. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove or refute the alleged violation occurred; therefore, this allegation is deemed Unsubstantiated.

An exit interview was conducted with Administrator and a copy of this LIC9099 report was left at facility.

SUPERVISOR'S NAME: Sheila Santos	TELEPHONE: (714) 334-2062
LICENSING EVALUATOR NAME: Ruth Martinez	TELEPHONE: (657) 285-1397
LICENSING EVALUATOR SIGNATURE:	DATE: 05/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/31/2022

LIC9099 (FAS) - (06/04)

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