565800622-10-24-2022-29-AS-JAPL-CKN4F4-20221028190319

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 565800622
Report Date: 10/24/2022
Date Signed: 10/24/2022 01:33:21 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
10/12/2022 and conducted by Evaluator Ashley Smith

COMPLAINT CONTROL NUMBER: 29-AS-20221012100733

FACILITY NAME:	A BRADLEY HOUSE		FACILITY NUMBER:	565800622
ADMINISTRATOR:	CHARISSE BRADLEY		FACILITY TYPE:	740
ADDRESS:	4031 APRICOT ROAD		TELEPHONE:	(805) 578-1933
CITY:	SIMI VALLEY	STATE: CA	ZIP CODE:	93065
CAPACITY:	6	CENSUS: 4	DATE:	10/24/2022
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Walfre 'Walter' Alvizures		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Staff is force-feeding resident
Staff left resident in soiled diapers
Staff threw diapers at resident
Staff yells at resident
Staff slaps resident while providing incontinence care
Staff is forcing resident to take unprescribed medications

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ashley Smith arrived unannounced to conduct a subsequent visit to issue the findings. The LPA met with Walfre 'Walter' Alvizures and the LPA explained the reason for the visit.

During the 10/17/2022 visit, the LPA interviewed staff at 9:02 a.m., 9:07 a.m., 9:25 a.m., 9:42 a.m., and 10:05 a.m.; interviewed facility residents at 10:30 a.m,.12:40 p.m. and 12:46 p.m.; interviewed Resident #1 (R1) at 11:03 a.m.; interviewed R1's family member at 11:39 a.m.; and, interviewed a hospital social worker at 12:15 p.m. A facility plant tour was conducted at 10:35 a.m., and the LPA obtained documents pertinent to the investigation. The LPA interviewed an additional staff member on 10/18/2022 at 8:42 a.m.

CONT 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Ashley Smith	TELEPHONE: (818) 421-9032
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2022

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 4

Control Number 29-AS-20221012100733

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: A BRADLEY HOUSE	FACILITY NUMBER: 565800622
	VISIT DATE: 10/24/2022

NARRATIVE

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Regarding the allegation: Staff is force-feeding resident
It was alleged that staff forced food in Resident #1’s (R1) mouth. Interviews with R1 claimed that R1 wanted to be ‘left alone’ and alleged that staff ‘forced food’ in R1’s mouth. Staff denied claims that they placed food in R1’s mouth without consent from R1. Staff claimed that R1 could feed themselves but said that at times, R1 was weak and had to be assisted with feeding. Staff denied claims that R1 ever became combative or upset when eating meals, as it may have indicated they had to stop assisting R1. Staff mentioned that R1 did not consume a lot of food during meal times and that staff would document the amount of food R1 ate. Staff said they never forced R1 to eat, nor did they force food in R1's mouth. Based on the information obtained, there is insufficient information to support claims that staff force-fed R1. This allegation is deemed Unsubstantiated at this time.

Regarding the allegation: Staff left resident in soiled diapers
It was alleged that staff failed to change R1 timely, and R1 was left soiled. R1 reported that they had to call the staff when they wanted to be changed. Yet staff interviews revealed that they would check on residents regularly to ensure that they were changed in a timely manner. One staff alleged that R1 once had an accident and soiled their linens, yet R1 refused to get up and said it was ‘fine’. Staff said they had to coerce R1 into letting them change the sheets. One staff referenced an interaction they had with R1 when R1 would refuse assistance with going to the restroom or to being changed. Residents communicated that they felt that their hygiene needs were met and noted that staff changed them regularly. Residents denied claims that they were left in soiled diapers. Based on the information obtained, there is insufficient evidence to support the claim that staff left residents in soiled diapers. This allegation is deemed Unsubstantiated at this time.

Regarding the allegation: Staff threw diapers at resident
It was alleged that staff threw a diaper at R1. R1 reported that Staff #1 (S1) became angry at R1 when R1 soiled their linens and S1 threw a diaper at them. S1 denied claims that they threw a diaper at R1 and described their interactions with R1 as pleasant. In general, all staff denied throwing an item at R1, or any resident. R1’s family member stated they were comfortable with R1 residing in this facility and said that due to past experiences and R1’s dislike of care facilities, R1’s family believed that R1’s claims had the potential to lack validity. Information obtained from resident interviews revealed that residents had not had things thrown at them. Residents did not have any negative things to say about the staff. There is insufficient evidence to support the claim that staff threw diapers at R1. This allegation is deemed Unsubstantiated at this time.

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Ashley Smith	TELEPHONE: (818) 421-9032
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2022

LIC9099 (FAS) - (06/04)

Page: 4 of 4

Control Number 29-AS-20221012100733

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: A BRADLEY HOUSE	FACILITY NUMBER: 565800622
	VISIT DATE: 10/24/2022

NARRATIVE

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Regarding the allegation: Staff yells at resident
It was alleged that staff yelled at R1. R1 reported that when they called staff for assistance, staff would respond by yelling at them. Staff claimed that they were responsive to all resident needs and denied claims that they had ever yelled at R1 or any resident. Staff said that if a resident had become combative or verbally aggressive, they respond calmly. Staff believed they responded to resident requests timely and respectfully. R1’s family member stated that they were comfortable with R1 residing in this facility and stated that due to past experiences with R1’s dislike of residing at care facilities, R1’s family member believed that R1’s claims have the potential to lack validity. R1’s family member claimed that they had not had negative interactions with the facility staff. Residents stated they had not been yelled at by the staff. Residents did not have any negative things to say about the staff. Based on the information obtained, there is insufficient evidence to support the claim that staff yelled at residents. This allegation is deemed Unsubstantiated at this time.

Regarding the allegation: Staff slaps resident while providing incontinence care
It was alleged that staff slapped R1 while providing incontinent care. R1 alleged that they were slapped because they were ‘bothering’ staff. Staff denied all claims that they had slapped R1 while providing care. Staff said that if a resident had become combative or physically aggressive towards them, they would calmly respond. R1’s family member stated that they were comfortable with R1 residing in this facility and stated that due to past experiences with R1’s dislike of residing at care facilities, R1’s family member believed that R1’s claims have the potential to lack validity. R1’s family member claimed that they had not had negative interactions with the facility staff. Residents claimed that staff had appropriate relationships with the residents and denied claims that staff had ever been physically abusive. Residents did not have any negative things to say about the staff. Based on the information obtained, there is insufficient evidence to support the claim that staff slaps residents. This allegation is deemed Unsubstantiated at this time.

Regarding the allegation: Staff is forcing resident to take unprescribed medications
It was alleged that staff were ‘shoving’ pills in R1’s mouth and forcing R1 to take 'unprescribed sleeping pills'. Staff claimed that they only assisted R1 with taking medications that were prescribed to them and denied claims that they had given R1 unprescribed medications. A review of R1’s medication list revealed that R1 was prescribed Trazodone, which is a medication known to treat anxiety and depression. However, according to Mayo Clinic, it is also known as an effective sleep aid. However a review of R1’s medication administration record revealed that the Trazodone was prescribed to R1.

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Ashley Smith	TELEPHONE: (818) 421-9032
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 29-AS-20221012100733

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: A BRADLEY HOUSE	FACILITY NUMBER: 565800622
	VISIT DATE: 10/24/2022

NARRATIVE

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Staff stated R1 was compliant when assisting R1 with the self-administration of prescribed medication and R1 did not refuse to take medications. Residents claimed that they received assistance with the self-administration of medications and did not communicate any concerns. Although R1 is no longer here, the LPA observed medications during today's visit and did not observe any errors nor discrepancies. Residents at this facility appeared to be taking medications prescribed to them.

Based on the information obtained, there is insufficient evidence to support the claim that staff were forcing R1 to take unprescribed medications. This allegation is deemed Unsubstantiated at this time.

No deficiencies cited at this time. Exit interview conducted. A copy of the report was issued.

SUPERVISOR'S NAME: Jeralyn Ann Pfannenstiel	TELEPHONE: (818) 596-4343
LICENSING EVALUATOR NAME: Ashley Smith	TELEPHONE: (818) 421-9032
LICENSING EVALUATOR SIGNATURE:	DATE: 10/24/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/24/2022

LIC9099 (FAS) - (06/04)

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