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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 331880511
Report Date: 06/27/2021
Date Signed: 06/29/2021 02:23:03 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/03/2020 and conducted by Evaluator Shaunte Henry
PUBLIC
COMPLAINT CONTROL NUMBER: 18-AS-20200903133044
FACILITY NAME:PALMS AT LA QUINTA, THEFACILITY NUMBER:
331880511
ADMINISTRATOR:PATRICK MCADOO-MORTONFACILITY TYPE:
740
ADDRESS:45160 SEELY DRIVETELEPHONE:
(760) 345-5353
CITY:LA QUINTASTATE: CAZIP CODE:
92253
CAPACITY:120CENSUS: 53DATE:
06/27/2021
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Michelle Walker, AdministratorTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Insufficient staffing to meet resident needs
INVESTIGATION FINDINGS:
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On 6/27/21, Licensing program Analyst (LPA) Shaunte Henry conducted an unannounced visit for the purpose of delivering the finding to the above allegation, LPA met with Administrator Michelle Walker, explained the nature of the visit and was granted entry.

An interview with Executive Director Patrick McAdoo-Morton revealed that the facility does not have a sufficient amount of staff due to the COVID-19 pandemic. The ED reported requesting additional staffing from outside agencies. The ED reported the staffing shortage to Community Care Licensing (CCL) as required.

Based on LPAs observations and interviews, which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

An exit interview was conducted where this report was discussed with and provided to the Administrator.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Nedra BrownTELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Shaunte HenryTELEPHONE: (951) 217-0236
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 18-AS-20200903133044
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1650 SPRUCE ST STE 200 MS29-27
RIVERSIDE, CA 92507

FACILITY NAME: PALMS AT LA QUINTA, THE
FACILITY NUMBER: 331880511
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/27/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/28/2021
Section Cited
CCR
87411(a)
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Personnel Requirements Facility personnel shall at all times be sufficient in numbers, and competent to provide the services necessary to meet resident needs.

This requirement was not met as evidened by:
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The facility will ensure that staffing is sufficient at all times. It is noted that the COVID-19 pandemic is the cause of the shortage, therefore the facility shall have a plan in place to address staffing shortages.
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Based on an interview with the Executive Director, the facility has insufficient staffing due to the COVID-19 pandemic.

This is an immediate health and safety risk for residents in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Nedra BrownTELEPHONE: (951) 202-5776
LICENSING EVALUATOR NAME: Shaunte HenryTELEPHONE: (951) 217-0236
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2021
LIC9099 (FAS) - (06/04)
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