306006071-2-21-2025-22-AS-AORZ-DFMTEZ-20250411144047

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 306006071
Report Date: 02/21/2025
Date Signed: 02/21/2025 05:22:59 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 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
02/14/2025 and conducted by Evaluator Michael Tea

COMPLAINT CONTROL NUMBER: 22-AS-20250214164901

FACILITY NAME:	PALMS RETIREMENT CENTER		FACILITY NUMBER:	306006071
ADMINISTRATOR:	BARRIENTOS, ELEANOR		FACILITY TYPE:	740
ADDRESS:	312 N ROOSEVELT AVE		TELEPHONE:	(626) 353-4710
CITY:	FULLERTON	STATE: CA	ZIP CODE:	92832
CAPACITY:	144	CENSUS: 110	DATE:	02/21/2025
		UNANNOUNCED	TIME BEGAN:	12:50 PM
MET WITH:	Eleanor Barrientos		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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- Facility staff is not acting to prevent a bed bug infestation

INVESTIGATION FINDINGS:

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On this day, Licensing Program Analyst (LPA) Michael Tea made an unannounced visit to conduct a complaint investigation. LPA Tea was greeted and granted entry into the facility by Assistant Administrator (AA) Kathleen Tamondong and explained the reason for the visit. Administrator (AD) Eleanor Barrientos arrived later to assist with the visit.

The department received a complaint on February 14, 2025 and LPA Tea conducted the initial 10 day visit a week later on February 21, 2025. It was alleged that facility staff is not acting to prevent a bed bug infestation. LPA Tea interviewed facility staff and residents and collected pertinent documents such as staff and resident rosters, copies of Resident 1 (R1)’s file, and pest control maintenance paperwork and log. The investigation determined the following:

Report continued on LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Michael Tea
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025

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-20250214164901

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
ORANGE COUNTY RO, 770 THE CITY DR., SUITE 7100
ORANGE, CA 92868

FACILITY NAME: PALMS RETIREMENT CENTER	FACILITY NUMBER: 306006071
	VISIT DATE: 02/21/2025

NARRATIVE

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Per review of pest control maintenance paperwork and service logbook, facility currently has no bed bugs as shown in a recent service report from the facility’s pest maintenance company dated February 20, 2025. AA Tamondong said that pest control comes to inspect the facility quarterly and as needed. However there was a bed bug infestation reported on December 19, 2024 in which the facility was treated for. The following service report on January 2, 2025 shows that there are no evidence of bed bugs in the facility since December.

Six out six staff interviewed said that there are no bed bugs currently and they react right away to contain and treat any infestation of bed bugs. All staff interviewed noted the facility check the rooms, gather clothes and bedding and wash and treat them. Afterwards facility maintenance staff clean and spray chemicals to treat for bed bugs. Then pest control comes out for prevention and maintenance.

Per interviews, eight out twelve residents agree that the facility was doing a good job in preventing and acting upon bed bug infestations and pests. LPA Tea interviewed Resident 1 (R1) who felt there was no urgency or quick action when addressing a possible bed bug infestation. R1 said they felt itchy and the bites felt like goosebumps or “chill bumps.” R1 said the facility was slow to respond and check their room. While interviewing R1, LPA Tea was making observations and saw no visible bite marks on R1. LPA Tea inspected R1 and their roommate’s bed and the areas around and observed no bed bugs at the time. Per interviews, two out of two maintenance staff who checked R1’s room confirmed there were no bed bugs in the room. Maintenance staff checked and treated R1’s room upon report of possible bed bugs. AA Tamondong noted that pest control will do another inspection on February 24, 2025.

Therefore, based on LPA Tea's observations and interviews conducted and records reviewed the allegation that facility staff is not acting to prevent a bed bug infestation has been determined to be unsubstantiated meaning that although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred.

No deficiencies cited at this time and an exit interview was conducted with Administrator Eleanor Barrientos and Assistant Administrator Kathleen Tamondong. A copy of the report and confidential names list was provided to the facility.

SUPERVISORS NAME: Alisa Ortiz
LICENSING EVALUATOR NAME: Michael Tea
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025

LIC9099 (FAS) - (06/04)

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