<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197608908
Report Date: 06/25/2020
Date Signed: 06/25/2020 01:59:29 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., STE. 250
WOODLAND HILLS, CA 91364
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/18/2020 and conducted by Evaluator Tuesday Cabiness
PUBLIC
COMPLAINT CONTROL NUMBER: 31-AS-20200318143402
FACILITY NAME:MONTECEDROFACILITY NUMBER:
197608908
ADMINISTRATOR:DAVID WEIDERTFACILITY TYPE:
741
ADDRESS:2212 EL MOLINOTELEPHONE:
(626) 396-7125
CITY:ALTADENASTATE: CAZIP CODE:
91001
CAPACITY:300CENSUS: 213DATE:
06/25/2020
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:David Weidert TIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Medical insturments are not being cleaned between usage of residents
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19), and to implement mitigation measures, Licensing Program Analyst (LPA) Tuesday Cabiness delivered the final findings of the complaint investigation telephonically with Executive Director David Weidert. The following was determined:

Concerns were expressed that medical instruments were not being cleaned when being used between residents. On March 20, 2020 and June 23, 2020, LPA conducted a virtual tour, interviewed staff, and obtained facility documentation pertaining to the complaint. LPA determined, that during the initial stages of COVID-19, the facility followed the guidelines implemented by the Department of Public Health (DPH), Community Care Licensing (CCLD), and Centers for Disease Control (CDC). LPA was able to telephonically able to visual the facilities procedures that were implemented for staff, residents, and visitors who entered the facility. Interviews conducted revealed, that nurses, and the front desk receptionist, who was trained by medical professionals, are the only ones who use the medical instruments (thermometers) on staff and residents. LPA observed the procedures during the virtual tour, and determined that the facility followed
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Tuesday CabinessTELEPHONE: (818) 299-4975
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2020
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 31-AS-20200318143402
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., STE. 250
WOODLAND HILLS, CA 91364
FACILITY NAME: MONTECEDRO
FACILITY NUMBER: 197608908
VISIT DATE: 06/25/2020
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
the proper procedures when using thermometers, observed they were cleaned and sanitized after every use. Although, the complainant, who was anonymous, LPA was not able to interview or obtain more information regarding the allegation mentioned above. Therefore, through interviews conducted and observations, LPA determined that the allegation medical instruments not being cleaned between residents, is UNSUBSTANTIATED at this time.
SUPERVISOR'S NAME: Cassandra HarrisTELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Tuesday CabinessTELEPHONE: (818) 299-4975
LICENSING EVALUATOR SIGNATURE:

DATE: 06/25/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/25/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2