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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 197607718
Report Date: 08/16/2021
Date Signed: 08/18/2021 09:37:55 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
07/20/2021 and conducted by Evaluator Ana Soto
PUBLIC
COMPLAINT CONTROL NUMBER: 11-AS-20210720081934
FACILITY NAME:CENTINELA ASSISTED LIVING CENTREFACILITY NUMBER:
197607718
ADMINISTRATOR:GWENDOLYN CRAIGFACILITY TYPE:
740
ADDRESS:1000 S FLOWER STTELEPHONE:
(310) 674-3216
CITY:INGLEWOODSTATE: CAZIP CODE:
90301
CAPACITY:96CENSUS: 49DATE:
08/16/2021
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Gwendolyn Craig, AdministratorTIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
2
3
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5
6
7
8
9
Staff fail to ensure residents receive mail in a prompt manner.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Ana Soto conducted a subsequent complaint investigation to conduct further investigation and deliver findings and decisions for the allegation listed above. Today’s complaint investigation was conducted with Gwendolyn Craig, the facility administrator.

The investigation consisted of following: Interviews and Record reviews. On 07/30/21, LPA Soto interviewed medical assistant Laura Lopez. On 08/16/21, LPA Soto interviewed Administrator Gwendolyn, S#3, R#1 – R#5. Toured rooms #2, #41, #23, and #16 and dining room, patio, and administrator office, and medication room. LPA Soto received the following documents on 08/16/21: Resident Roster & Staff Schedule, mail procedures.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ana Soto
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2021
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 11-AS-20210720081934
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1000 CORPORATE DR #100
MONTEREY PARK, CA 91754
FACILITY NAME: CENTINELA ASSISTED LIVING CENTRE
FACILITY NUMBER: 197607718
VISIT DATE: 08/16/2021
NARRATIVE
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Based on the LPA's investigation, the investigation revealed the following. For Allegation #1 - Staff fail to ensure residents receive mail in a prompt manner. Interviews with Administrator, S#1, & S#3, they all stated that the mail is delivered to the resident the same day it arrives. The mail is distributed by the administrator, medicine technician, or care givers. The residents also come to the front office to get their mail. The administrator also stated that mail is received by the receptionist at the skilled nursing side, she then separates it and gives the Assisted Living side their mail every day. Interviews with R#2, R#4, & R#5, stated that they always get their mail on time. The mail is never late. The LPA witnessed that the mail for 08/16/21 was reviewed, marked, and ready to be distributed. The interviews and records reviewed do not concur with the above 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

An exit interview was conducted with Gwendolyn Craig, Administrator, and a hard copy was provided.
SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Ana Soto
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2