306005636-9-18-2024-22-AS-LMOA-DBEA7Q-20241126225841

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306005636
Report Date: 09/18/2024
Date Signed: 09/18/2024 03:09:11 PM

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
09/09/2024 and conducted by Evaluator Claudia Gutierrez

PUBLIC

COMPLAINT CONTROL NUMBER: 22-AS-20240909104554

FACILITY NAME:	MAINPLACE SENIOR LIVING		FACILITY NUMBER:	306005636
ADMINISTRATOR:	RHONWINN HIPOLITO		FACILITY TYPE:	740
ADDRESS:	1800 1832 W. CULVER AVENUE		TELEPHONE:	(714) 978-2534
CITY:	ORANGE	STATE: CA	ZIP CODE:	92868
CAPACITY:	153	CENSUS: 112	DATE:	09/18/2024
		UNANNOUNCED	TIME BEGAN:	12:15 PM
MET WITH:	Ruby Racca-Magao		TIME COMPLETED:	03:25 PM

ALLEGATION(S):

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Facility staff are not ensuring air conditioning is maintained in good repair
Facility staff are not preventing physical altercations between residents

INVESTIGATION FINDINGS:

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An unannounced Complaint Investigation was conducted on this day by Licensing Program Analysts (LPAs) Claudia Gutierrez and Samer Haddadin regarding the allegations mentioned above. LPAs met with Wellness Director (WD) Ruby Racca-Magao and explained the purpose of the inspection.

Interviews were conducted with four facility staff, and seven residents regarding allegation, facility staff are not ensuring air conditioning is maintained in good repair. Two of four staff interviewed stated the air conditioning did not appear to be working in areas of the facility last week, however, the issue has since been repaired by maintenance staff. Two of four staff stated the air conditioning was operational last week and continues to be operational this week. One of seven residents interviewed stated they were unsure if the air conditioning was operational last week but stated the air conditioning is currently operational. One of seven residents stated the air conditioning was operational last week and continues to be operational. Five of seven residents stated the air conditioning had not been operational last week, however, it was repaired within a week and is currently operationing. (LIC9099-C)

Unsubstantiated

Estimated Days of Completion: 90

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Claudia Gutierrez	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024

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-20240909104554

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: MAINPLACE SENIOR LIVING	FACILITY NUMBER: 306005636
	VISIT DATE: 09/18/2024

NARRATIVE

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Interviews were conducted with four facility staff, and seven residents regarding allegation, facility staff are not preventing physical altercations between residents. Four of four staff interviewed denied witnessing or having any knowledge of any physical altercations between residents. Six of seven residents denied witnessing or having any knowledge of physical altercations between residents taking place. One of seven residents denied personally having a physical altercation with another resident, however, indicated they were involved in a verbal altercation with another resident at an unknown time in the past.

During the complaint investigation, LPAs and WD conducted a tour of the facility and observed the air conditioning to be operating as designed and room temperature tested between 76- and 82- degrees Fahrenheit. LPAs observed residents in common areas and resting in their respective bedrooms without disturbance, and no physical altercations between residents were observed.

Based on observations and due to conflicting information received during interviews conducted, LPA is unable to determine if facility staff are not ensuring air conditioning is maintained in good repair or if facility staff are not preventing physical altercations between residents. 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 and copy of this report was provided at the end of the inspection.

SUPERVISOR'S NAME: Armando J Lucero	TELEPHONE: (714) 703-2840
LICENSING EVALUATOR NAME: Claudia Gutierrez	TELEPHONE: 714-703-2840
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024

LIC9099 (FAS) - (06/04)

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