198601529-9-29-2020-31-AS-CHAS-BUTSB2-20201028134312

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198601529
Report Date: 09/21/2020
Date Signed: 09/29/2020 04:12:33 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
07/08/2020 and conducted by Evaluator Rosaura Valenzuela

COMPLAINT CONTROL NUMBER: 31-AS-20200708105341

FACILITY NAME:	HIGHLAND PARK GUEST HOME, INC.		FACILITY NUMBER:	198601529
ADMINISTRATOR:	ROBERT S. IVES JR		FACILITY TYPE:	735
ADDRESS:	345 N. AVE 57		TELEPHONE:	(323) 529-4267
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90042
CAPACITY:	40	CENSUS: 39	DATE:	09/21/2020
		UNANNOUNCED	TIME BEGAN:	09:18 AM
MET WITH:	Maria Lopez		TIME COMPLETED:	09:19 AM

ALLEGATION(S):

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Staff make inappropiate comments to residents

Staff are not providing residents with adequate supplies

INVESTIGATION FINDINGS:

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LIcensing Program Analyst (LPA) Rosaura Valenzuela conducted subsequent complaint investigation for the above noted allegations. Due to the situation surrounding the Coronavirus Disease 2019 (COVID-19) and to implement mitigation measures, today's complaint investigation was conducted telephonically with facility assistant administrator, Maria Lopez. The purpose of the visit was discussed.

It was reported that staff use the "N" word and call residents "crackheads." To investigate the allegation on 7/17/20 at 1:30pm, LPAs Valenzuela and Gillyard spoke with facility staff. Staff indicated that they have never used the "N" word or call residents "crackheads." On 7/17/20 at 2:00pm, LPA Valenzuela spoke to facility residents. The residents interviewed during the investigation denied ever hearing the "N" word used or staff referring to them as "crackheads." Moreover, interviews revealed that the facility staff are nice and respectful to all facility residents. On 8/26/20, LPA Valenzuela was given a copy of an incident report dated 8/24/20, which states that resident #1 (R1) was cursing and using the "N" word at another client.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Rosaura Valenzuela	TELEPHONE: (818) 421-5360
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2020

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 31-AS-20200708105341

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: HIGHLAND PARK GUEST HOME, INC.	FACILITY NUMBER: 198601529
	VISIT DATE: 09/21/2020

NARRATIVE

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Based on the information revealed during the investigation, there is no relevant information to support the allegation. Therefore, the allegation is UNSUBSTANTIATED at this time.

Staff are not providing residents with adequate supplies.

It was reported that residents do not receive adequate supplies of toilet paper. On 7/17/20 at 2:00pm, LPA Valenzuela spoke to facility residents. The residents interviewed during the investigation denied not being given adequate supplies of toilet paper, toothpaste, and other toiletries. Moreover, staff showed LPA a storage room with adequate supplies of toilet paper and other toiletries. Bathrooms were inspected and toilet paper was observed.

Based on interviews and observation, it has been determined that the facility does provide adequate supplies of toilet paper and other toiletries. Thus, the allegation is deemed UNSUBSTANTIATED.

This concludes the investigation.

Exit interview conducted. Signature obtained on hard copy of the report.

SUPERVISOR'S NAME: Cassandra Harris	TELEPHONE: (818) 596-4342
LICENSING EVALUATOR NAME: Rosaura Valenzuela	TELEPHONE: (818) 421-5360
LICENSING EVALUATOR SIGNATURE:	DATE: 09/18/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2020

LIC9099 (FAS) - (06/04)

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