561703573-6-1-2023-29-AS-DPEA-CSYUVN-20230620155521

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 561703573
Report Date: 06/01/2023
Date Signed: 06/01/2023 04:00:37 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, 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
05/23/2023 and conducted by Evaluator Teresa Camara

PUBLIC

COMPLAINT CONTROL NUMBER: 29-AS-20230523161635

FACILITY NAME:	ELMS RESIDENTIAL CARE		FACILITY NUMBER:	561703573
ADMINISTRATOR:	HIGGINS, FE LILIA 98		FACILITY TYPE:	740
ADDRESS:	67 EAST BARNETT		TELEPHONE:	(805) 643-2176
CITY:	VENTURA	STATE: CA	ZIP CODE:	93001
CAPACITY:	54	CENSUS: 42	DATE:	06/01/2023
		UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Fe HIggins		TIME COMPLETED:	01:55 PM

ALLEGATION(S):

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Facility is not sufficiently staffed to meet the needs of residents in care.
Facility staff do not ensure residents are taking their medications.
Facility staff are not assisting residents with showers.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Teresa Camara conducted an initial complaint visit regarding the above noted allegations. LPA met with licensee/administrator Fe Higgins and explained the reason for the visit.

LPA interviewed ten (10) randomly chosen residents between 10:55 a.m. and 12:20 p.m. LPA interviewed administrator at 10:40 a.m. LPA interviewed three (3) staff between 11:35 a.m. and 12:46 p.m.

Regarding the allegation facility is not sufficiently staffed to meet the needs of residents in care:
All of the residents stated their needs are always met by facility staff and the administrator. They indicated sometimes staff do not show up to work and the administrator takes on those duties. However, even if staff call in sick, they still have all their needs met. Staff at the facility ensure they are fed, given their medications and assist them with their medical appointments. All of the staff who were interviewed stated they feel there

(continued on 9099-C; page 2)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Teresa Camara	TELEPHONE: 818-326-4019
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

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 29-AS-20230523161635

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: ELMS RESIDENTIAL CARE	FACILITY NUMBER: 561703573
	VISIT DATE: 06/01/2023

NARRATIVE

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(continued from 9099; page 1)

is enough staff at the facility. Staff acknowledged that when other staff call in sick it just means they may need to work more hours to complete their additional duties. Based on interviews with residents and staff, the allegation facility is not sufficiently staffed to meet the needs of residents in care is deemed unsubstantiated at this time.

Regarding the allegation facility staff do not ensure residents are taking their medications:
All of the residents confirmed they usually receive their medications while in the dining room during meals. They usually go to the dining room where the medication room is located to receive their nighttime medications around 7:00 p.m. If they do not make it to the medication room or dining room then the medication technicians or administrator will bring the medications to their room. All of the residents confirmed they take their medications right away in front of staff. The staff LPA interviewed are not medication technicians. There is a night shift staff who provides PRN medications and who is currently passing out the morning medications because the medication technician who usually does that is on leave at this time. Currently the administrator passes out medications for lunch, dinner and evening (7:00 p.m.). The administrator stated she makes sure medications are taken by residents. If a resident refuses a medication she takes the medication back and notes the medication was refused. Based on interviews, the allegation facility staff do not ensure residents are taking their medications is deemed unsubstantiated at this time.

Regarding the allegation facility staff are not assisting residents with showers:
All of the residents LPA interviewed stated they are capable of showering without assistance. Resident 1 (R1) stated they sometimes shower with the assistance of their family member but that is by choice. R1 stated if they needed assistance from staff all they have to do is ask for help. All of the staff LPA interviewed stated there are no residents at the facility who require assistance with showering. Residents stated the shower rooms at the facility are kept clean. LPA observed staff cleaning the facility, including the shower rooms, during the visit. Administrator stated residents who refuse to shower are reported to their responsible parties for additional intervention. Based on interviews and observations, the allegation facility staff are not assisting residents with showers is deemed unsubstantiated at this time.

No deficiencies observed. Exit interview conducted. A copy of the report was issued.

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Teresa Camara	TELEPHONE: 818-326-4019
LICENSING EVALUATOR SIGNATURE:	DATE: 06/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/01/2023

LIC9099 (FAS) - (06/04)

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