198320348-10-10-2024-11-AS-JHAD-DAJRAB-20241030125052

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 198320348
Report Date: 10/10/2024
Date Signed: 10/10/2024 11:45:21 AM

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
12/19/2023 and conducted by Evaluator Lizeth Villegas

COMPLAINT CONTROL NUMBER: 11-AS-20231219140341

FACILITY NAME:	VILLA DEL SOL		FACILITY NUMBER:	198320348
ADMINISTRATOR:	COELLO, BESSIE L.		FACILITY TYPE:	740
ADDRESS:	4834 NARROT ST.		TELEPHONE:	(310) 292-8425
CITY:	TORRANCE	STATE: CA	ZIP CODE:	90503
CAPACITY:	6	CENSUS: 6	DATE:	10/10/2024
		UNANNOUNCED	TIME BEGAN:	09:16 AM
MET WITH:	House manager Natalia		TIME COMPLETED:	12:37 PM

ALLEGATION(S):

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Facility did not prevent outbreak of covid.
Staff are not providing residents with food of good quality.
Staff does not provide nutritious meals to residents.
Staff unable to communicate residents needs due to language barrier.
Facility does not post menu.

INVESTIGATION FINDINGS:

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On 10/10/24 at 9:00 am, Licensing Program Analyst (LPA) Villegas conducted a subsequent complaint visit regarding the allegations above. LPA met with Director (S1) Bessie L. Coello as the purpose of today’s visit was explained.

The investigation consisted of the following: On 12/28/23 LPA Gibbs conducted initial visit, LPA Gibbs toured the facility, interviewed Staff 1-2 (S1-S2), and reviewed and received documents pertinent to the investigation. On 08/29/24 LPA Villegas Conducted interviews between 11am-11:45am with staff 1-2 (S1-S2), and obtained copies of the staff and resident rosters, menus, copies of the communication logs dated August 2023- November 2023, and copies of communication between S1 and R1's POA. On 08/29/24 LPA toured the facility and kitchen, LPA observed refrigerator and pantry to be fully stocked, LPA observed menus displayed, LPA observed plenty of PPE to be accessible, and LPA also had temperature taken upon entry of the facility. On 08/29/24 LPA obtained copies of documents pertinent to the investigation for resident #2 (R2). On 10/10/24 between 9am-12:00 pm LPA Villegas conducted interviews with residents # R2-R5 (R2-R5). On 10/10/24 LPA Villegas was unable to interview R6-R7 due to communication barriers.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024

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-20231219140341

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: VILLA DEL SOL	FACILITY NUMBER: 198320348
	VISIT DATE: 10/10/2024

NARRATIVE

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The investigation revealed the following: Allegation: Facility did not prevent outbreak of covid.

It is being alleged that in October 2023 there was an outbreak of covid as many residents were affected, and R1 was not tested positive. On 08/29/24 between 11am-11:45am LPA Villegas conducted interview with S1 regarding the allegation above, S1 denied the allegation above and stated, there were covid cases at the facility but not at the same time. Per S1, CCLD and families are made aware of positive cases as well as covid protocols are followed by all staff. On 08/29/24 between 11am-11:45am LPA Villegas conducted interview with S2 regarding the allegation above, S2 denied the allegation above and reported residents who tested positive for covid tested positive at different times. Per S2, all staff were trained on the covid protocols. On 10/10/24 between 9am-12 pm LPA Villegas conducted interviews with residents#2-5(R2-R5) regarding the allegation above, 3 out of 4 residents interviewed denied the allegation above. 1 of 4 residents interviewed reported testing positive for covid and isolating outside of the facility per families request.On 10/10/24 LPA Villegas was unable to interview R6-R7 due to communication barriers. On 10/10/23 LPA Villegas reviewed the report sent to CCLD on 10/09/2023 by S1 regarding covid positive residents in care. LPA also reviewed the infection control disease plan in place for the facility. Covid positive case(s) were also reported to public health department.

Allegation: Staff are not providing residents with food of good quality.

It is being alleged that there is “very sparse” amount of food in the facility fridge. On 08/29/24 between 11am-11:45am LPA Villegas conducted interview with S1 regarding the allegation above, S1 denied the allegation above and reported groceries are purchased weekly or multiple times a week as needed via Instacart delivery services. On 08/29/24 between 11am-11:45am LPA Villegas conducted interview with S2 regarding the allegation above, S2 denied the allegation above and reported groceries are purchased 2 times a week or as needed. On 08/29/24 LPA Villegas conducted a tour of the kitchen and observed there was a 7-day supply of perishable and non-perishable food available, LPA observed the food in the pantry to be labeled with expiration dates. On 10/10/24 between 9am-12 pm LPA Villegas conducted interviews with residents 2-5(R2-R5) regarding the allegation above, 4 of 4 residents interviewed denied the allegation above. On 10/10/24 LPA Villegas was unable to interview R6-R7 due to communication barriers.

Allegation: Staff does not provide nutritious meals to residents. It is being alleged that the facility is providing food that is not nutritious as no vegetables are served and the meals are not balanced. On 08/29/24 between 11am-11:45am LPA Villegas conducted interview with S1 regarding the allegation above, S1 denied the allegation above and reported that residents have not

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024

LIC9099 (FAS) - (06/04)

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Control Number 11-AS-20231219140341

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: VILLA DEL SOL	FACILITY NUMBER: 198320348
	VISIT DATE: 10/10/2024

NARRATIVE

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complained about the food being served. On 08/29/24 between 11am-11:45am LPA Villegas conducted interview with S2 regarding the allegation above, S2 denied the allegation above and reported that residents have not complained about the food being served and if they did staff accommodate with different options. On 08/29/24 LPA observed lunch being served and enjoyed by the residents, LPA observed vegetables and salad being served with protein. On 10/10/24 between 9am-12pm LPA Villegas conducted interviews with residents 2-4 (R2-R5) regarding the allegation above, 4 of 4 residents interviewed denied the allegations above. On 10/10/24 LPA Villegas was unable to interview R6-R7 due to communication barriers.

Allegation: Staff unable to communicate residents needs due to language barrier.

It is being alleged that facility staff do not understand residents when residents are asking or needing something. On 08/29/24 between 11am-11:45am LPA Villegas conducted interview with S1 regarding the allegation above, S1 denied the allegation above and reported staff are able to communicate clearly with the residents. On 08/29/24 between 11am-11:45am LPA Villegas conducted interview with S2 regarding the allegation above, S2 denied the allegation above. On 10/10/24 between 9am-12pm LPA Villegas conducted interviews with residents 2-4 (R2-R5) regarding the allegation above, 4 of 4 residents interviewed denied the allegation above. On 10/10/24 LPA Villegas was unable to interview R6-R7 due to communication barriers.

Allegation: Facility does not post menu.

It is being alleged that facility does not post menu.

On 08/29/24 LPA Villegas obtained copies of facility menus, menus were observed to have written details for breakfast, lunch, and dinner. On 10/10/24 LPA Villegas conducted tour of the kitchen and observed menu to be posted. Facility is in compliance with section 87555 (b)(6) which indicates, “In facilities for sixteen (16) persons or more, menus shall be written at least one week in advance and copies of the menus as served shall be dated and kept on file for at least 30 days. Facilities licensed for less than sixteen (16) residents shall maintain a sample menu in their file. Menus shall be made available for review by the residents or their designated representatives and the licensing agency upon request.”

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.

Exit interview conducted with house manager Natalia Torres, and a copy of this report was provided.

SUPERVISORS NAME: Janae Hammond
LICENSING EVALUATOR NAME: Lizeth Villegas
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024

LIC9099 (FAS) - (06/04)

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