197609943-8-25-2023-31-AS-NMAN-CV9MYL-20230901100142

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 197609943
Report Date: 08/25/2023
Date Signed: 08/25/2023 02:42:59 PM

Unsubstantiated

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
10/18/2022 and conducted by Evaluator LaQueena Lacy

COMPLAINT CONTROL NUMBER: 31-AS-20221018132814

FACILITY NAME:	JOCELYN'S LOVING CARE		FACILITY NUMBER:	197609943
ADMINISTRATOR:	ESPIRITU, JOCELYN		FACILITY TYPE:	740
ADDRESS:	803 N GENESEE AVE		TELEPHONE:	(323) 592-3100
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90046
CAPACITY:	6	CENSUS: 5	DATE:	08/25/2023
		UNANNOUNCED	TIME BEGAN:	01:38 PM
MET WITH:	Jocelyn Espiritu		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Facility staff did not inform family of residents death.

Facility staff did not release body to authorized representative.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) LaQueena Lacy conducted an unannounced subsequent complaint visit to deliver findings on 08/25/2023 at 1:45pm. Upon arrival LPA met the Administrator Jocelyn Espiritu and explained the purpose of this visit.

#1. Facility staff did not inform family of residents death.

It is alleged that R1 daughter in law was attempting to locate R1 and found out on 10/18/22, that R1 had been admitted to Jocelyn's Loving Care and had passed away on 10/17/22. To investigate the above allegation, on 10/20/2022 LPA Tuesday Cabiness conducted interviews with the administrator and requested copies of documents relevant to the investigation between 10:30am -11:30am. On 12/28/2023 at 1:00pm LPA Lacy requested additional documents relevant to the investigation and interviewed the administrator at 1:41pm.
Continued on LIC9099C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: LaQueena Lacy
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2023

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-20221018132814

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: JOCELYN'S LOVING CARE	FACILITY NUMBER: 197609943
	VISIT DATE: 08/25/2023

NARRATIVE

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During the investigation, interviews with the administrator revealed that R1 lived at home with their Power of Attorney (POA) prior to being admitted to the facility on 08/19/2022 and was receiving hospice care prior to being admitted. Upon record review on 12/28/2022 at 1:00pm of the facility Identification and Emergency Information and Courageous Care Hospice documentation shows the only family information or responsible party listed is R1s POA. Based on interviews, observations, and record review there is not enough corroborating evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED at this time.
issued.

#2. Facility staff did not release body to authorized representative.

It is alleged that the administrator refused to provide the attorneys or the daughter in law information on the funeral home or the current location of R1s body. To investigate the above allegation, LPA interviewed the administrator and it was revealed that she was contacted by a paralegal from an attorney’s office questioning her about the location of R1s body, she informed the caller that the POA was informed of R1s location, and requested documentation to release the requested information to them, the caller became angry and stated, “I will just report you to licensing”. R1s POA was notified immediately upon R1s death and arrived at the facility and was present along with Courageous Care Hospice agency until R1s body was retrieved by the mortuary. Upon record review, of R1s admission agreement they were admitted to the facility on 08/19/2022 and the only person listed as a responsible party is R1s POA. R1s hospice admission records are signed and list R1s POA for contact dated for 07/29/2023. Based on interviews, observations, and record review there is not enough corroborating evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED at this time.

No health and safety hazards are noted during this visit.

No deficiencies cited, exit interview conducted, copy of report and appeal rights issued.

SUPERVISORS NAME: Naira Margaryan
LICENSING EVALUATOR NAME: LaQueena Lacy
LICENSING EVALUATOR SIGNATURE:	DATE: 08/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/25/2023

LIC9099 (FAS) - (06/04)

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