198320326-1-23-2025-11-AS-UCOL-DD93BZ-20250124170707

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320326
Report Date: 01/09/2025
Date Signed: 01/23/2025 03:00:57 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
12/31/2024 and conducted by Evaluator Jose Calderon

COMPLAINT CONTROL NUMBER: 11-AS-20241231122907

FACILITY NAME:	MANNY'S CARE FACILITY		FACILITY NUMBER:	198320326
ADMINISTRATOR:	NAHUM, MANACHA		FACILITY TYPE:	740
ADDRESS:	1782 S SHERBOURNE DRIVE		TELEPHONE:	(310) 309-0405
CITY:	LOS ANGELES	STATE: CA	ZIP CODE:	90035
CAPACITY:	6	CENSUS: 6	DATE:	01/09/2025
		UNANNOUNCED	TIME BEGAN:	09:16 AM
MET WITH:	ADMINISTRATOR ELIAT NAHUM		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff did not meet a resident's hygiene needs
Staff are retaliating against a resident

INVESTIGATION FINDINGS:

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This is an amendment of the report dated 01/09/2025 to clarify the details of the investigation, the complaint investigation findings remain Unsubstantiated.
Community Care Licensing Division (CCLD) conducted an unannounced visit to Manny’s Care Facility on 01/09/2025 and was greeted by Administrator Eliat Nahum (S1). CCLD staff explained the purpose of this visit is to deliver the findings pertaining to the above-mentioned allegations.
The investigation consisted of the following: CCLD staff interviewed Administrator (S1), staff (S1-S3), residents (R1-R4). CCLD staff requested and reviewed copies of the following: Physician Report (dated 08/22/2023), Needs and Service plan (dated 09/01/2024), shower/sponge bath logs (date 01/09/2025). CCLD staff toured the facility with S1.
The investigation revealed the following:

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Calderon
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2025

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 11-AS-20241231122907

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: MANNY'S CARE FACILITY	FACILITY NUMBER: 198320326
	VISIT DATE: 01/09/2025

NARRATIVE

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Regarding Allegation #1: Staff did not meet a residents hygiene need.

It is being alleged that resident was not given a shower and had feces on resident body prior to being taken to the hospital for a medical procedure. CCLD staff toured the facility and noted the facility was clean. CCLD staff observed residents to be dressed in neat and clean clothes. CCLD staff did not observe any smell of incontinence or feces during interviews. CCLD staff reviewed bath/sponge bath logs (date January 2025), physician report (date 08/22/2023), needs and service plan (date 09/01/2024), for 1 of 4 residents. Records indicate that 1 resident needs assistance taking a sponge bath. Sponge bath log notes indicate that staff has given 1 resident a sponge bath daily. Interviews revealed the following: 3 out of 3 staff denied the allegation. 3 out of 3 staff indicate that a resident had taken laxative prior to the medical procedure, resident was given a sponge bath and diaper change prior to being taken to the hospital. 3 out of 4 residents indicate that they take a bath 1 or 2 times per week and staff does not prevent them from taking a shower. 1 out of 4 residents does not remember if they had feces on their body prior to being taken to the hospital and they were sleeping when they took the medical test.

Regarding allegation: Staff are retaliating against a resident.

It is being alleged that a staff retaliated towards a resident after filing complaints against the facility. During the investigation CCLD staff toured the facility and noted no negative interactions between staff and residents. CCLD staff reviewed physician report (date 08/22/2023), needs and service plan (date 09/01/2024), shower/sponge bath log notes (date 01/09/2025) for a resident. 3 out of 3 staff denied the allegation and staff indicate that staff never had any issues with any resident. 1 out of 4 residents indicate that staff has retaliated towards other residents for making complaints. 3 out of 4 residents indicate that staff has never retaliated towards them.

Based on interviews, observations, and supporting documentation, the preponderance of evidence standard has not been met; therefore, the allegations of “staff did not meet a residents hygiene need”, “staff are retaliating against a resident” is found to be UNSUBSTANTIATED.

No deficiencies cited during today's visit.

An exit interview was conducted, and a copy of the Complaint Report was provided to the Administrator Eliat Nahum S1.

SUPERVISORS NAME: Ulysses Coronel
LICENSING EVALUATOR NAME: Jose Calderon
LICENSING EVALUATOR SIGNATURE:	DATE: 01/09/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2025

LIC9099 (FAS) - (06/04)

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