197609336-8-22-2022-11-AS-EMAZ-CK6UZ7-20221013160104

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609336
Report Date: 08/22/2022
Date Signed: 08/22/2022 06:20:45 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/17/2022 and conducted by Evaluator Ernand Dabuet

PUBLIC

COMPLAINT CONTROL NUMBER: 11-AS-20220817141932

FACILITY NAME:	WELBROOK SENIOR LIVING SANTA MONICA		FACILITY NUMBER:	197609336
ADMINISTRATOR:	KRISTIN BECK		FACILITY TYPE:	740
ADDRESS:	1450 17TH STREET		TELEPHONE:	(424) 282-3002
CITY:	SANTA MONICA	STATE: CA	ZIP CODE:	90404
CAPACITY:	50	CENSUS: 38	DATE:	08/22/2022
		UNANNOUNCED	TIME BEGAN:	09:34 AM
MET WITH:	Henry Rivas & Kristin Beck		TIME COMPLETED:	03:31 PM

ALLEGATION(S):

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Facility telephone is in disrepair

INVESTIGATION FINDINGS:

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On 08/22/22 Licensing Program Analyst (LPA) Ernand Dabuet conducted an unannounced complaint visit at this facility. LPA Dabuet was greeted by Executive Director Kristin Beck. LPA Dabuet discussed the purposed of today's visit

The investigation included the following; A review of the Client roster, Staff roster, Face sheet, Physician's Report, Preplacement Appraisal, ID/Emergency, and other pertinent documents associated with Resident #1 (R1). Interviews were conducted with staff #1-#3 (S1-S3) and residents #1-#3 (R1-R3). A tour of the facility was conducted with Business Office Manager Henry Reyes.

Evaluation Report continues on LIC 9099C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Ernand Dabuet	TELEPHONE: (323) 629-5526
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2022

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 11-AS-20220817141932

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754

FACILITY NAME: WELBROOK SENIOR LIVING SANTA MONICA	FACILITY NUMBER: 197609336
	VISIT DATE: 08/22/2022

NARRATIVE

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INVESTIGATION REVEALED THE FOLLOWING:

Allegation: The facility telephone is in disrepair.
The details of the complaint allege the facility had technical related telephone issues. The complaint states it is impossible to get a hold of staff. The complaint states that three months have passed and the issue persists.

The Department interview staff #1 (S1) who was named by the complainant explains that the facility's mainline for the Front Desk/Concierge is always operable. The general hours for the front desk are 8:30 am through 5:30 pm. Any incoming calls after 5:30 pm through 8:30 am are considered after hours. These calls are answered by the evening staff on two portable telephones. However, when several incoming calls come through the mainline after hours at the same time; the calls are then routed back to the mainline for callers to leave a voicemail message. An interview with staff #2 (S2) confirmed that the internal telephone system has always worked. (S1-S3) all verified when multiple incoming calls are received after hours at the same time; the calls will be routed back to the front desk and the caller will be given an option to leave a message. The overflow of incoming calls after hours if not answered by a staff person; calls will be directly routed to the front desk or now have the option to be routed to the medical technician department. Interviews with resident #1-#3 (R1-R3) all expressed their satisfaction, contentment, and gratification with staff. (R1-R3) all gave compliments on how the staff is responsive and accessible in all forms of communications. The Department was provided a telephone log for dates the complainant alleges the phone system was in disrepair. Evidence show calls were received by the facility and the phone system was in working condition. The caller terminated the calls. Based on information gathered, an inspection of the facility, observation, analysis of (R1)'s service records, and interviews conducted, the Department found no evidence to support the allegation mentioned above.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation, did or did not occur, therefore the allegation is Unsubstantiated.

No deficiencies were cited during this visit.
An exit interview was conducted with Kristin Beck, and a copy of the report was provided.

SUPERVISOR'S NAME: Eva M Alvarez	TELEPHONE: (323) 629-7047
LICENSING EVALUATOR NAME: Ernand Dabuet	TELEPHONE: (323) 629-5526
LICENSING EVALUATOR SIGNATURE:	DATE: 08/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/22/2022

LIC9099 (FAS) - (06/04)

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