306005182-8-13-2021-22-AS-MSTC-C6R242-20210910170314

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005182
Report Date: 08/13/2021
Date Signed: 08/13/2021 02:03:59 PM

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
02/13/2020 and conducted by Evaluator Sean Haddad

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20200213154648

FACILITY NAME:	BOK SENIOR HOTEL		FACILITY NUMBER:	306005182
ADMINISTRATOR:	PAK, HOPE		FACILITY TYPE:	740
ADDRESS:	1100 E WHITTIER BLVD		TELEPHONE:	(714) 529-1697
CITY:	LA HABRA	STATE: CA	ZIP CODE:	90631
CAPACITY:	340	CENSUS: 85	DATE:	08/13/2021
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Marty Oh		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff yells at residents.
Facility not kept clean.
Facility has fleas.
Facility is malodorous.

INVESTIGATION FINDINGS:

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This unannounced inspection is being conducted by Licensing Program Analyst (LPA) Sean Haddad for the purpose of delivering findings for the investigation into the above identified complaint allegations. LPA met with Operating Manager (OM) Marty Oh and explained the reason for today’s inspection.

The investigation into allegations that staff yells at residents, facility not kept clean, facility has fleas, and facility is malodorous revealed the following:

During the course of the investigation, Licensing Program Analysts (LPAs) Lydia Martinez and James August conducted an on-site inspection on 2/24/20, toured the facility, interviewed Administrator (AD) Hope Pak, 1 witness, and 4 residents, and obtained and reviewed copies of resident and staff files. On 2/13/20, a resident reported that Staff #1 (S1) yells at the residents often and that recently S1 yelled at Resident #1 (R1) because R1’s cat and their litterbox were left out in front of their room. (Page 1)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Marina Stanic	TELEPHONE: (714) 703-2851
LICENSING EVALUATOR NAME: Sean Haddad	TELEPHONE: (714) 335-7094
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021

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-20200213154648

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: BOK SENIOR HOTEL	FACILITY NUMBER: 306005182
	VISIT DATE: 08/13/2021

NARRATIVE

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However, R1 stated that staff never yell at them and they have never heard any staff yelling at anyone. LPAs interviewed 3 additional residents who similarly stated they had never heard anyone yelling at anyone and had never heard staff yelling at any resident. On 2/13/20, a resident reported that the litter box outside the door of R1’s room had not been cleaned for weeks, had feces and urine in it, and was causing the hallway to “reek” with the smell of feces and urine. However, R1 denied having a cat, explaining that they once had a cat living in their room but that the cat was removed about a year prior. In addition, LPAs observed R1’s room to be clean and free from odor and LPAs interviewed 3 additional residents who stated the facility and their rooms are clean. A witness reported that on 3/12/20 they observed an upstairs room (described as the “activity room” or “wellness room”) was dusty and dirty. However, this specific instance does not by itself demonstrate a violation. On 2/13/20, a resident reported that the facility has fleas due to the cat from R1’s room and that this resident has had fleas on their person several times. R1 stated they did not have a cat in their room in the last year or fleas in their room, further stating they never had any bug bites. LPAs interviewed 3 additional residents who denied experiencing issues with fleas.

Based on the information gathered during the investigation and review of all documents obtained, the Department is unable to ascertain if the allegations of facility staff yells at residents, facility not kept clean, facility has fleas and facility is malodorous occurred as reported. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove or refute the alleged violations occurred; therefore, these allegations are deemed Unsubstantiated.

An exit interview was conducted and a copy of this report and appeal rights was discussed with and provided to facility representative. (Page 2, End)

SUPERVISOR'S NAME: Marina Stanic	TELEPHONE: (714) 703-2851
LICENSING EVALUATOR NAME: Sean Haddad	TELEPHONE: (714) 335-7094
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2021

LIC9099 (FAS) - (06/04)

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