421703341-9-1-2021-29-AS-KBUY-C7BPWS-20210929114112

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 421703341
Report Date: 09/01/2021
Date Signed: 09/01/2021 04:57:32 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/29/2021 and conducted by Evaluator Darlene Chavez

COMPLAINT CONTROL NUMBER: 29-AS-20210129111432

FACILITY NAME:	PITA BOARD AND CARE		FACILITY NUMBER:	421703341
ADMINISTRATOR:	CHRISTINE PITA		FACILITY TYPE:	740
ADDRESS:	259 MOONCREST		TELEPHONE:	(805) 934-2649
CITY:	SANTA MARIA	STATE: CA	ZIP CODE:	93455
CAPACITY:	6	CENSUS: 3	DATE:	09/01/2021
		UNANNOUNCED	TIME BEGAN:	09:27 AM
MET WITH:	Gloria Pita, Licensee, and Christine Pita, Administrator		TIME COMPLETED:	03:50 PM

ALLEGATION(S):

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Staff speaks inappropriate to the residents
Staff is not assisting resident with incontinence needs
Staff is rough with residents
Staff scolds residents

INVESTIGATION FINDINGS:

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On 9/01/21 at 9:27 am, Licensing Program Analysts (LPAs) Darlene Chavez and Toan Luong initiated a meeting to discuss the allegations listed above and deliver final findings. LPAs met with Gloria Pita, Licensee, Christine Pita, Administrator, and Staff #1 (S1) and explained the purpose of today’s visit.

On the allegation “Staff speaks inappropriate to the residents”, the complainant’s concern was that residents are not being treated with respect by staff. To investigate the allegation, LPA Chavez interviewed the complainant, licensee, administrator, and staff, and reviewed facility records. LPA Luong interviewed residents.

Continued on 9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Darlene Chavez	TELEPHONE: (805) 450-0283
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2021

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 3

Control Number 29-AS-20210129111432

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: PITA BOARD AND CARE	FACILITY NUMBER: 421703341
	VISIT DATE: 09/01/2021

NARRATIVE

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On 2/02/2021 at 1:57 pm, LPA Chavez spoke with licensee who stated that she has never heard or seen this happen. On 9/01/21 at 9:27 am, LPA spoke with licensee, administrator, and S1 regarding the allegation. They said they speak in a normal tone and sometimes raise their voices slightly when Resident #1 (R1) instigates an argument. On 9/01/21 at 9:42 am, LPA Luong spoke with Resident #2 (R2) who stated that staff treat R2 and other residents well. R2 states they are unaware of any yelling. On the same day at 9:52 am, LPA Luong spoke with Resident #3 (R3) who stated they have not heard any yelling and that staff treat residents “pretty well.” The facility’s house rules are posted next to the dining room table stating “Treat others with respect and care.” LPA confirmed with licensee and administrator that the house rules are reviewed with residents frequently. In documentation review, LPA Chavez found that all residents have signed a copy of the House Rules. Based on the information obtained, the allegation that, “Staff speaks inappropriate to the residents”, is Unsubstantiated.

On the allegation “Staff is not assisting resident with incontinence needs”, the complainant stated that a resident’s diapers are not being changed frequently and the facility smells bad. To investigate the allegation, LPA Chavez interviewed the licensee, administrator, and staff, and LPA Luong interviewed residents.

On 2/02/2021 at 1:57 pm, LPA Chavez spoke with licensee who explained that first thing in the morning when R4 wakes up, R4 needs the diaper changed. Licensee admits “It smells very bad” and S1 changes the diaper at “about 7:00 am daily as well as before lunch and then again before or after dinner.” Licensee reports that R4 occasionally will ask for help outside of these times. On 9/01/21 at 9:42 am and 9:52 am, LPA Luong interviewed R2 and R3 respectively who responded that there is “no odd smell” and staff keep the facility “clean.” Based on the information obtained, the allegation that, “Staff is not assisting resident with incontinence needs”, is Unsubstantiated.

On the allegation “Staff is rough with residents”, the complainant was concerned about an incident where a temporary worker handled a resident’s arm a bit roughly. To investigate the allegation, LPAs Chavez and Luong visited the facility on 9/01/21 at 9:27 am and interviewed licensee, administrator, staff, and residents. Licensee, administrator and staff stated they had no knowledge of an incident where staff handled residents roughly. LPA Chavez interviewed licensee on 2/02/21 at 1:57 pm who responded that the only time she recalls staff grabbing residents was when they assist residents with getting into or out of a chair. She states that occasionally staff help R3 with walking and demonstrated how staff hold R3’s arm near the elbow. On 9/01/21 at 9:42 am, LPA Luong interviewed R2 who stated “Staff are so familiar with handling people.” Based on the information obtained, the allegation that, “Staff is rough with residents”, is Unsubstantiated.
Continued on 9099-C.

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Darlene Chavez	TELEPHONE: (805) 450-0283
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 29-AS-20210129111432

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 21731 VENTURA BLVD. #250
WOODLAND HILLS, CA 91364

FACILITY NAME: PITA BOARD AND CARE	FACILITY NUMBER: 421703341
	VISIT DATE: 09/01/2021

NARRATIVE

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On the allegation “Staff scolds residents”, concerns were that staff reprimand and dismiss resident requests. To investigate, LPAs Chavez and Luong interviewed staff and residents. On 2/02/21 at 1:57 pm, LPA Chavez spoke with licensee who stated that R1 does and says things very often that are not appropriate and staff respond with comments to re-direct R1. On 9/01/21 at 9:45 am, Licensee stated that they do not scold. Licensee and administrator say that R1 “nit-picks” at every little thing, that R1 instigates, has their own rules, and doesn’t want to have boundaries” and that staff do the best they can to meet R1’s needs and de-escalate R1 behavior. In LPA Luong’s interviews with residents on 9/01/21 at 9:42 am and 9:52 am respectively, R2 states that “I have never been disappointed” in regards to staff support, and R3 states “residents are taken care of.” Based on the information obtained, the allegation that, “Staff scolds residents”, is Unsubstantiated.

At 3:50 pm, an exit interview was conducted with Gloria Pita, Licensee, and a copy of the report was given.

SUPERVISOR'S NAME: Kelly Burley	TELEPHONE: (805) 562-0413
LICENSING EVALUATOR NAME: Darlene Chavez	TELEPHONE: (805) 450-0283
LICENSING EVALUATOR SIGNATURE:	DATE: 09/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/01/2021

LIC9099 (FAS) - (06/04)

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