306005257-12-2-2022-22-AS-AJLO-CMAUPX-20221220144615

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005257
Report Date: 12/02/2022
Date Signed: 12/02/2022 11:56:17 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
06/28/2022 and conducted by Evaluator Claudia Gutierrez

COMPLAINT CONTROL NUMBER: 22-AS-20220628154736

FACILITY NAME:	CRESCENDO SENIOR LIVING		FACILITY NUMBER:	306005257
ADMINISTRATOR:	DALE WOYTEK		FACILITY TYPE:	740
ADDRESS:	351 EAST PALM DRIVE		TELEPHONE:	(714) 528-4990
CITY:	PLACENTIA	STATE: CA	ZIP CODE:	92870
CAPACITY:	138	CENSUS: 92	DATE:	12/02/2022
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Mirian Im		TIME COMPLETED:	11:15 AM

ALLEGATION(S):

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Insufficient staffing to meet resident needs.

Staff do not provide a safe environment for residents.

INVESTIGATION FINDINGS:

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An unannounced Complaint Investigation was conducted on this day by Licensing Program Analyst (LPA) Claudia Gutierrez regarding the allegations mentioned above for the purpose of delivering findings. LPA met with Wellness Director (WD) Mirian Im and took a guided tour of the facility.

Complaint alleges staff do not provide a safe environment for resident and insufficient staffing to meet resident needs.

Reporting party specified staff do not provide a safe environment because the back doors are always left open. On 7/22/2022 LPAs Claudia Gutierrez and Joseph Alejandre conducted a Complaint Investigation at the facility. During the visit, LPAs took a guided tour of the facility with former Executive Director (ED) Robert Jakini and observed back doors to the building were closed. The back doors are a one way exit and do not have a doorknob on the exterior therefore they cannot be opened from the outside. Per former ED the door remains closed due to the fact it is self-latching. (Cont. LIC9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Claudia Gutierrez	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 12/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022

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-20220628154736

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: CRESCENDO SENIOR LIVING	FACILITY NUMBER: 306005257
	VISIT DATE: 12/02/2022

NARRATIVE

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On a separate visit on 10/20/2022 LPA Claudia Gutierrez made an additional visit to the facility and took a guided tour with WD Mirian Im and again observed the doors to be closed. Interviews were conducted with former ED Robert Jakini, and staff regarding staff not providing a safe environment for residents. ED denied the allegation and stated the back doors are always closed as observed by LPA. Interviews were also conducted with three additional staff, and all denied staff do not provide a safe environment for residents. LPA interviewed two residents regarding the back doors being left open and both denied the doors are left open during the day or at nighttime.

Reporting Party specified that residents do not have enough care when they use their call buttons because “nobody shows up” and stated no one answers the phone after 5 p.m. Interviews were conducted with former ED regarding insufficient staffing to meet resident needs. Former ED denied that there was or is insufficient staffing to meet resident needs and stated that there are always two Caregivers and one Medication Technician on shift, day, or night; LPA Gutierrez confirmed that at least two Caregivers and one Medication Technician were on every shift for the month of June 2022 through staff time keeping records. Interviews were also conducted with staff and four out of four staff reported pendant calls are answered as soon as possible. LPA conducted a review of pendant call data records for the month of June 2022 and determined the average wait time for a pendant call was 12 minutes. Interviews were conducted with nine facility residents. Seven out of nine residents reported being assisted as needed and stated they felt staff met their needs. Two out of nine residents reported they “don’t need assistance.” Furthermore, LPA placed a call to the facility after 5 p.m. on three separate occasions, including facility staff dinner breaks, and weekends. Three out of three phone calls were answered by evening Medication Technicians who stated that after 5 p.m. the front desk phone calls are redirected to a cell phone they carry on their person throughout their shift.

Due to information received during interviews conducted, records review and after a review of facility grounds LPA is unable to determine if staff do not provide a safe environment for residents and if there is insufficient staffing to meet resident needs. Although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore at this time the above allegations are unsubstantiated.

An exit interview was conducted with WD Mirian Im. 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: 12/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2022

LIC9099 (FAS) - (06/04)

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