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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 198320082
Report Date: 03/06/2025
Date Signed: 03/06/2025 01:53:17 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/25/2025 and conducted by Evaluator Antonine Richard
COMPLAINT CONTROL NUMBER: 11-AS-20250225161122
FACILITY NAME:A CARING TOUCH BOARD AND CARE IIFACILITY NUMBER:
198320082
ADMINISTRATOR:WELLS, NICHOLASFACILITY TYPE:
740
ADDRESS:2108 OAK STTELEPHONE:
(510) 384-3431
CITY:SANTA MONICASTATE: CAZIP CODE:
90405
CAPACITY:6CENSUS: 5DATE:
03/06/2025
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Alison GaddiTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff did not provide accommodations to resident in care.
INVESTIGATION FINDINGS:
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On 03/06/2025, at 8:15 AM, Licensing Program Analyst (LPA), Antonine Richard, conducted an unannounced complaint visit to the facility above. LPA met with the Care giver Allison Gaddi, and the purpose of today's visit was explained. LPA was granted entry into the facily. At 8:25 AM, LPA spoke with the Administrator, Wells, Nicholas via the telephone.

Investigation consisted of the following: On 03/06/2025, LPA toured the facility, interviewed Staff S1-S3, interviewed residents R2-R5, and reviewed Resident Roster (dated 03/01/2025) staff roster (dated 03/01/2025), Medication Administration Record (MAR) from 02/03/2025 to 03/06/2025, Physician Report (dated 09/19/2024), After Doctor Visit Summary (dated 01/02/2025 to 02/11/2025) Appointment Desk-Future (dated 01/14/2025 to 08/07/2025). Appraisal/Needs and Services plan (dated 02/19/2025).

The investigation revealed the following:
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
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 11-AS-20250225161122
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: A CARING TOUCH BOARD AND CARE II
FACILITY NUMBER: 198320082
VISIT DATE: 03/06/2025
NARRATIVE
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Allegation: Staff did not provide accommodations to a resident in care.

The complaint details that there was a lot of noise coming from the heater and other equipment, which irritated resident ears.

During the visit on 03/06/2025, LPA Richard inspected all the residents' rooms and had staff turn on the heaters to inspect if they were noisy or malfunctioning. LPA observed the heater was operational and fully functional. When the heater was on there was normal noise coming out from the wall where the heater is located. However, when LPA Richard entered each of the resident rooms while the heater was on for thirty minutes LPA was not able to hear anything while in the resident room.

On 03/06/2025, from 10:30 AM to 11:00 AM, LPA interviewed Resident # 2- 5 about the allegation 4 out of 6 denied the allegation and stated they could not hear any noise when inside the room. On 03/06/2025, from 11:16 AM to 12:20 PM, LPA interviewed Staff #1-3; 3 out of 3 staff denied the allegation and stated that the heater noises were normal, and they could only hear the sound when in the living room where the heater is against the wall. LPA interviewed the Administrator who denied the allegation and stated that only one resident complained about noises coming from the room and insisted the hearing aids had an electric shot coming through the body. LPA interviewed Witness #1 who denied the allegation and stated that Resident #1, R1 had a hearing problem for years even though the doctor could not give any logical explanation for R1's hearing problems. During the file review, LPA received and reviewed the Appointment Desk and Future (dated 01/07/2025 to 08/07/25) indicating that R1 has been seen numerous times for Hearing Tests from R1's primary doctor. LPA was unable to interview Resident #1.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 11-AS-20250225161122
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
EL SEGUNDO ASC, 400 CONTINENTAL BLVD, STE 340
EL SEGUNDO, CA 90245
FACILITY NAME: A CARING TOUCH BOARD AND CARE II
FACILITY NUMBER: 198320082
VISIT DATE: 03/06/2025
NARRATIVE
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During the course of the investigation, LPA was unable to find evidence to support the allegation. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation (s) did or did not occur, therefore the allegation is unsubstantiated.

No deficiencies were cited. Exit interview conducted. A copy of this report was provided to the staff Allison Gaddi.

SUPERVISORS NAME: Eva M Alvarez
LICENSING EVALUATOR NAME: Antonine Richard
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3