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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197603385
Report Date: 02/01/2024
Date Signed: 02/01/2024 03:51:25 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/26/2024 and conducted by Evaluator Alma Gonzalez
PUBLIC
COMPLAINT CONTROL NUMBER: 28-AS-20240126125649
FACILITY NAME:COMMONWEALTH ROYALE GUEST HOMEFACILITY NUMBER:
197603385
ADMINISTRATOR:KITT, GARYFACILITY TYPE:
740
ADDRESS:150 S. COMMONWEALTH AVETELEPHONE:
(213) 382-6381
CITY:LOS ANGELESSTATE: CAZIP CODE:
90004
CAPACITY:99CENSUS: 88DATE:
02/01/2024
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Anna RempelTIME COMPLETED:
04:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not keep the facility free from bed bugs
Staff asked the residents for money while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Alma Gonzalez conducted an unannounced complaint visit to gather information pertaining to the above-mentioned allegations. LPA met with Administrator Anna Rempel and explained the reason for the visit.

The Investigation consisted of the following: LPA conducted interviews with Administrator Anna Rempel, Staff 1-4 (S1-4) and Residents 1-8 (R1-8). LPA obtained copies of Staff and Resident Rosters. LPA reviewed R1-8's facility files, collected copies of documents pertinent to the complaint investigation, and RNS Pest Elimation Service receipts. LPA also conducted a tour of facility which included observations of two floors and inspected a total of 5 resident bedrooms



(See LIC9099C for continuation)
Unsubstantiated
Estimated Days of Completion:
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Alma Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2024
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 3
Control Number 28-AS-20240126125649
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: COMMONWEALTH ROYALE GUEST HOME
FACILITY NUMBER: 197603385
VISIT DATE: 02/01/2024
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
Investigation revealed the following: Regarding allegation, Staff do not keep the facility free from bed bugs, it is alleged that a resident's bed has bed bugs and as a result the resident has pimple-like bumps on their legs. The resident allegedly informed facility staff and they did not take action. Interview with Administrator Rempel and facility staff revealed that the facility ensures that the facility is free from pests. They stated that pest control treats the facility monthly to ensure that the facility is free from pests. Staff deny that there are bed bugs at the facility or that any facility resident was bitten by bed bugs at the facility. Staff indicated there are no issues with bed bugs at this time. Facility has a contract with RNS Pest Elimination Services which treats the facility twice a month. LPA reviewed pest control company invoices for January 2024 and observed that the facility is treated for different pests including bed bugs and no activity was reported. 7 out of 8 residents interviewed indicated they have not seen any bed bugs in their rooms. 1 out of 8 residents stated that they have not seen bed bugs on their bed but do have bug bites on their legs and they have to be from bed bugs. LPA did not observe any bed bugs in the resident rooms that were toured. Based on interviews conducted with facility staff, facility residents, LPA observations and record review there was not enough supportive evidence to concur with the reported allegation.

For allegation, Staff asked the residents for money while in care, it is alleged that a new staff, who's name begins with an "L" and is either a caregiver or a housekeeping staff asked a resident for money. The resident did not give the staff any money. It is also reported that this same staff allegedly also asked another resident for money. Interviews conducted with facility staff revealed that they do not ever ask or take any residents money. Administrator stated that she has not gotten a complaint from any resident reporting that a staff is asking them for money. Administrator stated that if a resident reports that they have any missing belongings including any money they will document and investigate all alleged theft and loss of personal property. Staff will be responsible for searching for missing items and if items cannot be found, an estimate of the value will be assessed. If the theft amount exceeds $100.00, a report will be filed with appropriate law enforcement agency. S1 stated that a resident recently told them that a new staff asked them for money but that the resident did not give the staff money. S1 stated that she had not heard anything like that from any resident before and has never seen or heard from anyone else that a staff has asked a resident for money. Interviews conducted with 7 out of 8 residents revealed that facility staff have never asked them for money and they have not had any issues with their money. 1 out of 8 residents stated that 1 staff that is new attempted to ask them for money but they did not give the staff any money. 1 out of 8 residents stated that
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Alma Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 28-AS-20240126125649
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
GREATER LA AC/SC, 1000 CORPORATE CNTR DR. ST 500
MONTEREY PARK, CA 91754
FACILITY NAME: COMMONWEALTH ROYALE GUEST HOME
FACILITY NUMBER: 197603385
VISIT DATE: 02/01/2024
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
another resident was also asked for money by the same staff but they could not remember the other residents name and thinks they just now the resident's room number. Based on statements gathered from interviews conducted with staff and residents there was not enough supportive evidence to concur with the reported allegation.

Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.

Exit interview held. A copy of the report was provided to Administrator Anna Rempel.
NAME OF LICENSING PROGRAM MANAGER: Wei Siew Ho
NAME OF LICENSING PROGRAM ANALYST: Alma Gonzalez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 02/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3